Sex differences in incidence and mortality of bladder and kidney cancers: national estimates from 49 countries.

OBJECTIVES: In the United States, among patients diagnosed with bladder cancer (BC), women have increased disease-specific mortality compared with men. The main objective of this study was to determine whether this pattern is also present in other countries. For comparison, similar analyses were performed for kidney cancer (KC). METHODS AND MATERIALS: Data for this study were obtained from the GLOBOCAN 2008 database. A total of 49 countries with available information on BC and KC incidence and mortality were included in the analysis, representing all major geographic regions except Africa. For each country, we computed the sex-specific ratio of the total number of deaths from a given cancer to the total number of diagnoses in the year 2008 (the mortality-to-incidence ratio [MIR]). The relative MIR was computed for each country as a ratio of MIR in women to MIR in men. A relative MIR of more than 1 would indicate that the number of cancer-specific deaths relative to the number of cancer-specific diagnoses is greater in women than in men. RESULTS: For BC, the relative MIRs were significantly more than 1 in 26 countries (53%), significantly less than 1 in 2 countries (4%), and not significantly different from 1 in 21 countries (43%). The median relative MIR was 1.21 (interquartile range: 1.04-1.41). For KC, the relative MIRs were significantly more than 1 in 4 countries (8%), significantly less than 1 in 3 countries (6%), and not significantly different from 1 in 42 countries (86%). The median relative MIR was 1.00 (interquartile range: 0.94-1.06). CONCLUSION: Among BC patients, increased disease-specific mortality in women compared with men appears to be a common (although not a universal) phenomenon. This pattern may potentially be explained by differences between the sexes in the biology of disease, time to diagnosis, treatment decisions, and other factors. In contrast, among KC patients, no significant differences in disease-specific mortality were seen between the 2 sexes in the overwhelming majority of the countries.

Statin use and the risk of biochemical recurrence of prostate cancer after definitive local therapy: a meta-analysis of eight cohort studies.

UNLABELLED: What's known on the subject? and What does the study add? Over the last few years, several observational studies examined the association of statin use with the risk of biochemical recurrence of prostate cancer after definitive local therapy. The objective of our present study was to summarise available evidence on this subject using the method of meta-analysis. Combined evidence from eight cohort studies did not definitively support the hypothesis that statins influence the risk of biochemical recurrence. However, there was considerable disagreement between individual studies in reported findings and conclusions. OBJECTIVE: To perform a systematic review and meta-analysis of clinical studies with statin use as the exposure variable and biochemical recurrence after definitive local therapy for prostate cancer as the outcome. METHODS: Relevant publications were identified through PubMed/Medline/Embase databases. Pooled estimates of the hazard ratios (HRs) were computed using the inverse-variance weighting approach. Heterogeneity was assessed using the Cochran's Q test. RESULTS: We identified a total of eight eligible studies, all based on the retrospective cohort design. Five of these were based on radical prostatectomy (RP) series and three on radiotherapy (RT) series. There was evidence of heterogeneity in the entire set of eight studies (P = 0.002) as well as in the RP series (P = 0.05) and in the RT series (P = 0.01), when these were considered separately. Based on the random effects inverse-variance weighting approach, pooled estimates of the HRs for the risk of biochemical recurrence in statin users v non-users were 0.91 (95% confidence interval [CI] 0.72-1.13) for the entire set of eight studies, 1.02 (95% CI 0.80-1.29) for the RP series and 0.71 (95% CI 0.44-1.16) for the RT series. CONCLUSION: The pooled estimates of the HRs were not significantly different from the null value in this meta-analysis; however, evidence of heterogeneity between the studies was present.