High Prevalence of Smoking-Related Diseases in High-Grade and Muscle-Invasive Bladder Cancer: Opportunities for Lung Cancer Screening.

BACKGROUND/

OBJECTIVES

Bladder carcinoma (BC) is strongly associated with tobacco exposure, a major shared risk factor for several smoking-related diseases (SRDs), including pulmonary disorders and coronary atherosclerosis. However, the prevalence of SRDs in patients with high-grade (HGBC) or muscle-invasive bladder carcinoma (MIBC) has not been systematically investigated. We aimed to evaluate SRD prevalence and to assess the potential role of chest high-resolution computed tomography (HRCT) in a population with histologically confirmed HGBC or MIBC.

METHODS

We retrospectively analyzed 166 patients with histologically confirmed HGBC/MIBC who underwent staging HRCT. SRDs-including emphysema, suspicious pulmonary nodules, airway disease, interstitial lung disease (ILD), and coronary artery calcifications (CAC)-were assessed. Associations between smoking status and SRDs were evaluated using binary logistic regression, and odds ratios (OR) with 95% confidence intervals (CI) were calculated.

RESULTS

Overall, 60.2% of patients had at least one SRD. Smokers showed a significantly higher SRD prevalence than non-smokers (p < 0.05). Pulmonary SRDs were observed in 31.9% of patients, with emphysema being most strongly associated with smoking (p < 0.01). Suspicious pulmonary nodules (Lung-RADS ≥ 3) were detected in 6.6% of patients, more commonly among smokers (72.7%), though the difference was not statistically significant. Histological confirmation, available for 45% of these nodules, revealed primary lung cancers rather than metastatic bladder carcinoma in all verified cases.

CONCLUSIONS

Patients with HGBC/MIBC demonstrate a high prevalence of SRDs, supporting the integration of chest HRCT into staging protocols. HRCT may enable early detection of clinically relevant comorbidities and help identify candidates for lung cancer screening.