Meta-analyses have shown modest positive associations between diabetes mellitus (DM) and bladder cancer risk, but results are heterogeneous. This might be due to lack of distinction between bladder cancer subtypes, between sexes, and possibly between Type 2 and Type 1 DM (T2DM and T1DM). The relationship of T2DM (and secondarily T1DM) characteristics with risk of bladder cancer subtypes (invasive versus noninvasive) was investigated in the Netherlands Cohort Study. In 1986, 120,852 men and women aged 55–69 years provided information on DM and lifestyle data. After 20.3 years of follow-up, multivariable case-cohort analyses were based on 1020 invasive and 1088 noninvasive bladder cancer cases, and 4267 subcohort members with complete data on DM and confounders. While T2DM was not associated with noninvasive bladder cancer, it was statistically significantly associated with invasive bladder cancer risk: the multivariable-adjusted was HR = 1.57 (95% CI 1.04–2.37), comparing participants with T2DM versus without DM. The association was only significant in women, and women showed a stronger association [HR = 2.19 (95% CI 1.10–4.34)] between T2DM and invasive bladder cancer than men [HR = 1.42 (95% CI 0.88–2.30)]; interaction by sex was nonsignificant. Associations were stronger positive in those whose age at diagnosis of T2DM was 55+ years, and in those diagnosed with T2DM less than five years before baseline. T2DM participants using antidiabetic medication had higher invasive bladder cancer risk than those without DM. Exploratory age-sex-adjusted analyses suggested a positive association between T1DM and invasive bladder cancer, but this was based on few cases. These findings suggest that T2DM and possibly T1DM are positively associated with invasive bladder cancer risk.

荟萃分析显示，糖尿病 (DM) 与膀胱癌风险之间存在适度的正相关关系，但结果却存在差异。这可能是由于膀胱癌亚型、性别之间以及 2 型和 1 型 DM（T2DM 和 T1DM）之间缺乏区别所致。荷兰队列研究调查了 T2DM（其次是 T1DM）特征与膀胱癌亚型（侵袭性与非侵袭性）风险的关系。 1986 年，120,852 名 55-69 岁的男性和女性提供了有关 DM 和生活方式数据的信息。经过 20.3 年的随访，多变量病例队列分析基于 1020 例浸润性膀胱癌病例和 1088 例非浸润性膀胱癌病例，以及 4267 名具有 DM 和混杂因素完整数据的亚队列成员。虽然 T2DM 与非浸润性膀胱癌无关，但它与浸润性膀胱癌风险具有统计学显着相关性：将 T2DM 参与者与非 DM 参与者进行比较，多变量调整后的 HR = 1.57（95% CI 1.04–2.37）。这种关联仅在女性中显着，且女性 T2DM 与浸润性膀胱癌之间的关联性 [HR = 2.19 (95% CI 1.10–4.34)] 比男性更强 [HR = 1.42 (95% CI 0.88–2.30)]；性别间的相互作用不显着。在诊断 T2DM 年龄为 55 岁以上的患者以及在基线前不到 5 岁诊断为 T2DM 的患者中，相关性更强。使用抗糖尿病药物的 T2DM 参与者比未患 DM 的参与者患浸润性膀胱癌的风险更高。探索性年龄性别调整分析表明 T1DM 与浸润性膀胱癌之间存在正相关，但这是基于少数病例。这些发现表明 T2DM 和可能的 T1DM 与浸润性膀胱癌风险呈正相关。