(UroToday.com) The 2024 American Urological Association (AUA) annual meeting held in San Antonio, TX between May 3rd, and May 6th, 2024, was host to the bladder cancer epidemiology and evaluation moderated poster session. Dr. Khalid Alkhatib presented the results of a cross-sectional study using the CDC National Behavioral Risk Factor Surveillance System. They queried patients who self-reported ever being diagnosed with bladder cancer and aimed to examine the association between adverse mental health and smoking status.
Dr Alkhatib began by underscoring that approximately 50% of bladder cancer cases are linked to smoking, he showed that smoking has been associated with worse oncological outcomes, including higher recurrence rates and clinical progression. However, scant data has been published regarding the potential correlation between smoking status and the mental health and overall well-being of bladder cancer patients.
To address this gap, the investigators used the CDC National Behavioral Risk Factor Surveillance System, a comprehensive platform for health-related telephone surveys capturing data on U.S. residents' health behaviors, chronic conditions, and preventive service utilization. Spanning from 2016 to 2021, the researchers analyzed responses from individuals who self-reported a history of bladder cancer diagnosis. Adverse mental health was defined as individuals reporting ≥ 14 days per month with poor mental health. From a pool of over two and a half million participants, the study identified 1,118 individuals with bladder cancer. Notably, among these patients, 16.9% were current smokers, 52.5% were former smokers, and 30.6% had never smoked. Patient characteristics are shown below:
Dr. Alkhatib proceeded to demonstrate that among the bladder cancer cohort, 104 individuals (9.3%) reported experiencing poor mental health for ≥ 14 days per month. Using multivariable logistic regression, the researchers adjusted for various confounding factors, including:
- Age
- Time since diagnosis to survey
- Treatment status
- Income
- Marital status
- Exercise
- BMI
- History of depression
- History of coronary artery disease or myocardial infarction
- History of chronic kidney disease.
The multivariable analysis revealed that being a current smoker was independently associated with poorer mental health compared to individuals who had never smoked (OR 2.41, 95% CI 1.06 – 5.50, p=0.04). However, for former smokers, such an association was not observed (OR 0.96, 95% CI 0.46 – 2.00, p=0.91). Additionally, Dr. Alkhatib demonstrated that other factors, such as a history of depression (OR 6.54, 95% CI 3.57 – 12.00, p<0.01), were also associated with poor mental health.
Dr. Alkhatib concluded his presentation by emphasizing:
- In their study, being a current smoker was linked to poorer self-reported mental health among bladder cancer patients.
- He stressed the importance of actively screening these patients for depression and advocated for integrating their mental health into their follow-up care.
- He encouraged the adoption of smoking cessation programs in bladder cancer patients, highlighting the potential benefits for both oncologic outcomes and mental well-being.
Presented by: Khalid Alkhatib, MD, MMSc. Clinical Research Fellow, University of Pennsylvania, Philadelphia, PA
Written by: Julian Chavarriaga, MD - Society of Urologic Oncology (SUO) Clinical Fellow at The University of Toronto, @chavarriagaj on Twitter during the 2024 American Urological Association (AUA) annual meeting held in San Antonio, TX between May 3rd and May 6th, 2024