Examining the accuracy of self-reported smoking-related exposure among recently diagnosed nonmuscle invasive bladder cancer patients Journal Article


Authors: Petruzella, S.; Bochner, B. H.; Kenney, J.; Whiting, K.; Sadeghi, K.; Benfante, N.; Cha, E. K.; Dalbagni, G.; Donahue, T.; Donat, S. M.; Herr, H. W.; Pietzak, E.; Orlow, I.; Ostroff, J. S.; Furberg, H.
Article Title: Examining the accuracy of self-reported smoking-related exposure among recently diagnosed nonmuscle invasive bladder cancer patients
Abstract: PURPOSE: Cigarette smoking is a risk factor for developing nonmuscle invasive bladder cancer, and continued smoking exposure after diagnosis may increase the likelihood of adverse clinical outcomes. We compare self-reported vs biochemically verified nicotine exposure to determine the accuracy of self-report among recently diagnosed nonmuscle invasive bladder cancer patients. MATERIALS AND METHODS: This cross-sectional analysis consisted of 517 nonmuscle invasive bladder cancer patients who contributed a urine or saliva specimen the same day as self-reporting their smoking, use of e-cigarettes, nicotine replacement therapy and whether they lived with a smoker. Cotinine, the primary metabolite of nicotine, was used as an objective biomarker of recent nicotine exposure. RESULTS: The prevalence of high, low and no cotinine exposure was 13%, 54% and 33%, respectively. Overall, 7.3% of patients (38/517) reported being a current cigarette smoker, while 13% (65/517) had cotinine levels consistent with active smoking exposure. Of these 65 patients 27 denied current smoking, resulting in a sensitivity of self-reported current smoking of 58%. After considering other sources of nicotine exposure such as e-cigarettes, cigars, nicotine replacement therapy and living with a smoker, the sensitivity was higher, at 82%. Nearly all patients with low cotinine denied any smoking-related exposure. CONCLUSIONS: Our findings suggest either biochemical verification with cotinine or additional questions about other sources of nicotine are needed to accurately identify nonmuscle invasive bladder cancer patients who have smoking-related exposures. Accurate classification of active and passive smoking exposure is essential to allow clinicians to advise cessation and help researchers estimate the association between post-diagnosis smoking-related exposure and nonmuscle invasive bladder cancer recurrence risk.
Keywords: smoking; urinary bladder neoplasms; cotinine
Journal Title: Journal of Urology
Volume: 205
Issue: 5
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2021-05-01
Start Page: 1321
End Page: 1325
Language: English
DOI: 10.1097/ju.0000000000001571
PUBMED: 33356484
PROVIDER: scopus
PMCID: PMC9262154
DOI/URL:
Notes: Article -- Export Date: 1 June 2021 -- Source: Scopus
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MSK Authors
  1. Jamie S Ostroff
    344 Ostroff
  2. Guido Dalbagni
    325 Dalbagni
  3. Sherri M Donat
    174 Donat
  4. Irene Orlow
    247 Orlow
  5. Bernard Bochner
    470 Bochner
  6. Harry W Herr
    595 Herr
  7. Timothy Francis Donahue
    72 Donahue
  8. Eugene K. Cha
    100 Cha
  9. Nicole E Benfante
    162 Benfante
  10. Eugene J Pietzak
    117 Pietzak
  11. Jessica Marie Kenney
    7 Kenney
  12. Karissa A. Whiting
    50 Whiting