title: Bladder cancer mortality after spinal cord injury over 4 decades.
abstract: OBJECTIVE
  We estimate bladder cancer mortality in people with spinal cord injury compared to the general population.
  
  
  METHODS
  Data and statistics were retrieved from the National Spinal Cord Injury Statistical Center and the National Center for Health Statistics. The mortality experience of the 45,486 patients with traumatic spinal cord injury treated at a Spinal Cord Injury Model System or Shriners Hospital was compared to the general population using a standardized mortality ratio. The standardized mortality ratio data were further stratified by age, gender, race, time since injury and injury severity.
  
  
  RESULTS
  Our study included 566,532 person-years of followup between 1960 and 2009, identified 10,575 deaths and categorized 99 deaths from bladder cancer. The expected number of deaths from bladder cancer would have been 14.8 if patients with spinal cord injury had the same bladder cancer mortality as the general population. Thus, the standardized mortality ratio is 6.7 (95% CI 5.4-8.1). Increased mortality risk from bladder cancer was observed for various ages, races and genders, as well as for those injured for 10 or more years and with motor complete injuries. Bladder cancer mortality was not significantly increased for ventilator users, those with motor incomplete injuries or those injured less than 10 years.
  
  
  CONCLUSIONS
  Individuals with a spinal cord injury can potentially live healthier and longer by reducing the incidence and mortality of bladder cancer. Study findings highlight the need to identify at risk groups and contributing factors for bladder cancer death, leading to the development of prevention, screening and management strategies.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Stanford University, Stanford, California.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Nahm
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: yuyingchen@uabmc.edu.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: DeVivo
authors.affiliation: Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: L Keith
authors.initials: LK
authors.lastname: Lloyd
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000401:mortality*; D055815:Young Adult
keywords: mortality; spinal cord injuries; urinary bladder neoplasms