Reader response: Cancer incidence and mortality rates in multiple sclerosis: A matched cohort study
RalfDr. Böthig, Urologist, Surgeon, Department Neuro‑Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany
WolfgangDr. Schöps, Urologist, Urological Practice, Sankt Augustin, Germany
KlausProf. Dr. Golka, Occupational Physician, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany
Submitted December 17, 2020
We read with great interest the recent results of the study on multiple sclerosis (MS) and cancer risk.1 The described urinary bladder cancer risk is remarkable. Traumatic and congenital (spina bifida) spinal cord injury (SCI) patients usually suffer from neurogenic bladder dysfunction commonly associated with recurrent urinary tract infections. SCI patients are more likely to develop bladder cancer after paralysis lasts 10 years or more, at a younger age than the general population, and with a dramatically elevated mortality.2,3 This was also observed in a recent mono-centric study of 7,004 SCI patients who managed without chronic indwelling catheters.4 Thus, it would be very interesting if an association with the duration of MS and/or with the duration of the neurogenic bladder dysfunction was observable in the investigated bladder cancer patients. Also, the percentage of patients with a history of taking cyclophosphamide medication, well-known for its bladder carcinogenicity, and the proportion of squamous cell carcinomas to urothelial carcinomas, would be interesting. Squamous cell carcinomas are remarkably increased in SCI patients. 2,3,4 Furthermore, an association with urinary tract infections treated with antibiotics was found to be dose-dependent in a large Danish study, comprising 333 urinary bladder squamous cell carcinoma cases.5
Disclosure
The authors report no relevant disclosures. Contact [email protected] for full disclosures.
References
Marrie RA, Maxwell C, Mahar A, et al. Cancer incidence and mortality rates in multiple sclerosis: A matched cohort study. Neurology Epub 2020 Nov 25.
Ismail S, Karsenty G, Chartier-Kastler E, et al. Prevalence, management, and prognosis of bladder cancer in patients with neurogenic bladder: A systematic review. Neurourol Urodyn 2018;37:1386-1395.
Rove KO, Husmann DA, Wilcox DT, Vricella GJ, Higuchi TT. Systematic review of bladder cancer outcomes in patients with spina bifida. J Pediatr Urol 2017;13:456.e1-456.e9.
Böthig R, Tiburtius C, Fiebag K, et al. Traumatic spinal cord injury confers bladder cancer risk to patients managed without permanent urinary catheterization: lessons from a comparison of clinical data with the national database. World J Urol 2020;38:2827-2834.
Pottegård A, Kristensen KB, Friis S, Hallas J, Jensen JB, Nørgaard M. Urinary tract infections and risk of squamous cell carcinoma bladder cancer: A Danish nationwide case-control study. Int J Cancer 2020;146:1930-1936.
We read with great interest the recent results of the study on multiple sclerosis (MS) and cancer risk.1 The described urinary bladder cancer risk is remarkable. Traumatic and congenital (spina bifida) spinal cord injury (SCI) patients usually suffer from neurogenic bladder dysfunction commonly associated with recurrent urinary tract infections. SCI patients are more likely to develop bladder cancer after paralysis lasts 10 years or more, at a younger age than the general population, and with a dramatically elevated mortality.2,3 This was also observed in a recent mono-centric study of 7,004 SCI patients who managed without chronic indwelling catheters.4 Thus, it would be very interesting if an association with the duration of MS and/or with the duration of the neurogenic bladder dysfunction was observable in the investigated bladder cancer patients. Also, the percentage of patients with a history of taking cyclophosphamide medication, well-known for its bladder carcinogenicity, and the proportion of squamous cell carcinomas to urothelial carcinomas, would be interesting. Squamous cell carcinomas are remarkably increased in SCI patients. 2,3,4 Furthermore, an association with urinary tract infections treated with antibiotics was found to be dose-dependent in a large Danish study, comprising 333 urinary bladder squamous cell carcinoma cases.5
Disclosure
The authors report no relevant disclosures. Contact [email protected] for full disclosures.
References