Smoking is a known risk factor for bladder cancer, but a recent study suggests that smoking status is not significantly associated with recurrence of nonmuscle-invasive bladder cancer (NMIBC) among patients managed with blue light cystoscopy.

The study included 723 adults with NMIBC (11.5% with primary and 88.5% with recurrent NMIBC) managed with photodynamic enhanced (blue light) cystoscopy. Almost 73% of patients had high-risk disease, 52.6% were former smokers, and 12.7% were smokers at the time of entry into the multi-institutional registry used for the study.

Of the 723 patients, 259 (35.8%) experienced recurrence during a 3-year study period. The 1- and 3-year probability of recurrence was 19% and 44%, respectively, Richard S. Matulewicz, MD, of New York University Grossman School of Medicine in New York, New York, and colleagues reported online in Urologic Oncology. After adjusting for clinical and demographic factors, smokers were not at significantly increased risk for recurrence compared with never-smokers.

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Still, the importance of smoking cessation should not be dismissed, according to the investigators.

“Our findings should not be used to minimize the need for urologists to educate and counsel smokers who are diagnosed with bladder cancer,” Dr Matulewicz’s team cautioned. “Smoking cessation is critically important given the myriad health benefits of smoking cessation and all urologists should be screening for tobacco use during visits and improving how they help patients quit.”

Disclosure: The study was supported by Photocure, Inc.


Matulewicz RS, Ravvaz K, Weissert JA, et al. Association of smoking status and recurrence of non-muscle invasive bladder cancer among patients managed with blue light cystoscopy. Urol Oncol. Published online May 28, 2021. doi:10.1016/j.urolonc.2021.04.028