title: Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.
abstract: OBJECTIVE
  To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan.
  
  
  METHODS
  A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed.
  
  
  RESULTS
  The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P < 0.0001). Similar associations between smoking and the early diagnosis of upper tract urothelial carcinoma were shown in the sex subgroups and in subgroups stratified by pathological T stages. Among the current smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the < 20 cigarettes per day group, which was significantly different (P < 0.0001).
  
  
  CONCLUSIONS
  Current smoking is a significant risk factor for the earlier diagnosis of upper tract urothelial carcinoma. The finding is important from the perspective of both healthcare and medical economies.
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Urology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujimoto
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Koie
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Hinotsu
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, Tokyo, Japan.
authors.forename: Mizuaki
authors.initials: M
authors.lastname: Sakura
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Inokuchi
authors.affiliation: Working Group of the UTUC Registration Committee of the Japanese Urological Association, Tokyo, Japan.|Urology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Hara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014519:Ureterostomy; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D019459:Urothelium / Q000473:pathology*
keywords: Japanese; age at diagnosis; smoking; upper tract urothelial carcinoma