Study reveals potential new sign of urological cancer

Academics may have uncovered a new symptom for urological cancers in middle-aged adults, a study has suggested.

Urological cancers include those of the bladder and kidneys and in men the prostate, testicles and penis.

Symptoms can include blood in the urine, pain in the lower tummy or in one side of the lower back, needing to urinate more often than usual, difficulty urinating, an urgent need to urinate, feeling like the bladder is not empty after urinating, and a lump in the testicle, groin or on the penis.

Now it has been suggested that a bout of cystitis could be another “clinical marker” for urological cancer.

Cystitis is a common urinary tract infection (UTI) that affects the bladder.

A new study, published in the journal BMJ Public Health, examined data from 1.7 million men and 1.9 million women aged 50 and over from Sweden.

Of these, 177,736 men and 427,821 women were diagnosed with acute cystitis between 1997 and 2018.

Meanwhile, 199,144 men and 57,882 women were diagnosed with urogenital cancer – including 24,137 cases after cystitis.

Researchers found that the risk of urological cancer was higher among those who were diagnosed with cystitis, with the risk highest three months after diagnosis.

But these risks, measured as a standardised incidence ratio, persisted for several years afterwards for most urological cancers.

When researchers looked at the three months after a bout of cystitis, the risk for bladder cancer was nearly 34 times higher in men and 30 times higher in women.

They said the risks decreased over longer follow-up periods, and overall the risk of bladder cancer was 3-3.5% times higher among people diagnosed with cystitis.

Men who had a recorded cystitis infection had an 11 times higher risk of kidney cancer, and women had a nearly eight-times elevated risk in the three months after being diagnosed with cystitis, compared with those who were not diagnosed.

Again the risk decreased after a longer follow-up period, with the overall risk of kidney cancer nearly two times higher among those diagnosed with cystitis.

For prostate cancer, the risk within three months of infection was seven times higher in those who had had the infection than those who had not.

But the risk “disappeared” after a year.

For gynaecological cancers, the risk within three months of infection were between four and eight times higher among women who had had cystitis.

The authors said the risks were reduced during three to 12 months of follow-up, but “remained significant”.

“Acute cystitis can precede urogenital cancers in men and women aged 50 years (and over),” they wrote.

“The increased risks were particularly high within three months after the acute cystitis event and persisted for several years.”

The authors, led by academics at Lund University in Sweden, added: “Acute cystitis may act as a useful predictor of urogenital cancer in men and women aged 50 years and older.”

They said there are several possible explanations behind their findings, adding: “It is plausible that urogenital cancer, and perhaps even precancerous changes in the urogenital organ, might increase the risk of cystitis because of compromised urinary tract and host defence.

“Moreover, it is possible that certain occult urogenital cancers, especially urinary tract cancers, could present symptoms similar to those of cystitis, which might explain the particularly high risk of subsequent urogenital cancer shortly after the cystitis event.

“For clinicians, the findings indicate that acute cystitis could be a clinical marker for urogenital cancer.”