Lower Urinary Tract Symptoms and Risk of Bladder Cancer in Men: Results From the Health Professionals Follow-up Study.

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). Conclusion Our findings suggest that LUTS, especially urinary hesitancy, are associated with the development of bladder cancer in men.