title: Lower Urinary Tract Symptoms and Risk of Bladder Cancer in Men: Results From the Health Professionals Follow-up Study.
abstract: OBJECTIVE
  To understand the association between lower urinary tract symptoms (LUTS) and risk of bladder cancer in a large cohort of men.
  
  
  METHODS
  Using data from the Health Professionals Follow-up Study, we examined risk of bladder cancer in relation to severity of LUTS among 30,183 men. During the follow-up period from 1996 until 2010, 476 newly diagnosed cases of bladder cancer occurred. The Cox proportional hazards regression was used to adjust for potential confounders.
  
  
  RESULTS
  Among men with severe LUTS, risk of bladder cancer was 64% higher (relative risk [RR], 1.64; 95% confidence interval [CI], 0.87-3.08) compared with men who reported no LUTS. Subjects with both voiding and storage dysfunction had a significantly higher risk of bladder cancer (RR, 1.60; 95% CI, 1.00-2.56). Among individual urinary symptoms, urinary hesitancy was strongly associated with bladder cancer; those who experienced urinary hesitancy at least 50% of the time had more than twice the risk of bladder cancer (RR, 2.21; 95% CI, 1.29-3.78).
  
  
  CONCLUSIONS
  Our findings suggest that LUTS, especially urinary hesitancy, are associated with the development of bladder cancer in men.
authors: Department of Epidemiology, School of Public Health, Brown University, Providence, RI.
authors: Jiachen
authors: J
authors: Zhou
authors: Department of Epidemiology, School of Public Health, Brown University, Providence, RI; Department of Pathology and Laboratory Medicine, Brown University School of Medicine, Providence, RI.
authors: Karl T
authors: KT
authors: Kelsey
authors: Department of Nutrition, Harvard School of Public Health, Boston, MA.
authors: Scott
authors: S
authors: Smith
authors: Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors: Edward
authors: E
authors: Giovannucci
authors: Department of Epidemiology, School of Public Health, Brown University, Providence, RI; Department of Public Health and Community Medicine, Tufts University Medical School, Boston, MA. Electronic address: Dominique.Michaud@tufts.edu.
authors: Dominique S
authors: DS
authors: Michaud
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology*