title: Recurrent urinary tract infection and risk of bladder cancer in the Nijmegen bladder cancer study.
abstract: BACKGROUND
  Controversy exists on whether urinary tract infection (UTI) is a risk factor for urinary bladder cancer (UBC). Here, the association is investigated using data from one of the largest bladder cancer case-control studies worldwide.
  
  
  METHODS
  Information on (i) history and age at onset of regular cystitis ('regular low-UTI') and (ii) number and age at onset of UTI treated with antibiotics ('UTI-ab') from 1809 UBC patients and 4370 controls was analysed. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, education, smoking, and use of aspirin/ibuprofen were generated, for men and women separately.
  
  
  RESULTS
  Regular low-UTI was associated with an increased UBC risk (men: OR (95% CI) 6.6 (4.2-11); women: 2.7 (2.0-3.5)), with stronger effects in muscle-invasive UBC. Statistically significant decreased risks (ORs ∼0.65) were observed for up to five UTI-ab, specifically in those who (had) smoked and experienced UTI-ab at a younger age. In women, UTI experienced after menopause was associated with a higher UBC risk, irrespective of the number of episodes.
  
  
  CONCLUSIONS
  Regular cystitis is positively associated with UBC risk. In contrast, a limited number of episodes of UTI treated with antibiotics is associated with decreased UBC risk, but not in never-smokers and postmenopausal women.
authors.affiliation: Department for Health Evidence & Department of Human Genetics, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: S H
authors.initials: SH
authors.lastname: Vermeulen
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Hanum
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Grotenhuis
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, E-08003 Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Castaño-Vinyals
authors.affiliation: Department of Urology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: van der Heijden
authors.affiliation: 1] Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands [2] Comprehensive Cancer Centre the Netherlands, 3511 GD Utrecht, The Netherlands.
authors.forename: K K
authors.initials: KK
authors.lastname: Aben
authors.affiliation: Departments of Obstetrics & Gynecology, Pathology & Immunology, Washington University School of Medicine, 660S. Euclid Avenue, St. Louis MO 63110, USA.
authors.forename: I U
authors.initials: IU
authors.lastname: Mysorekar
authors.affiliation: Department for Health Evidence & Department of Urology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Kiemeney
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003556:Cystitis / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology*; D014552:Urinary Tract Infections / Q000453:epidemiology*