Purpose: To evaluate SIR of urothelial cancer with NHI data with age, gender stratification

1. Shuo-Meng Wang1 MD, Ming-Nan Lai, MD, Jung-Nien Lai, MD, Pau-Chung Chen, MD, Ph.D, Wei-Lum Tseng, MD, Ya-Yin Chen, MD, Jing-Shiang Hwang, PhD, and Jung-Der Wang, MD, Sc.DDepartment of Urology, National Taiwan University Hospital, Taiwan1 ; Institute of Occupational Medicine and Industrial Hygiene1, College of Public Health, National Taiwan University, Taiwan  Purpose: To evaluate SIR of urothelial cancer with NHI data with age, gender stratification Materials and Methods: In Taiwan, National Health Insurance (NHI) has been established since March 1995, which covered over 96% of all Taiwan residents. The files of the ‘Registry of Catastrophic Illnesses’ were also obtained for the years 1997 to 2002; these files include basic records on all patients with catastrophic illnesses, including ESRD, kidney transplants and urinary tract cancers (UTC) These two data sources were subsequently linked to identify and verify all positive diagnoses of ESRD . Detail is demonstrated as figure 1. Results: --20171 new patients with UTC in the whole Taiwan with 6816 (34%) females and 13355 (66%) males, and a mean age of 65.6 +/- 13.9 years --58120 patients with ESRD, 687 developed new UTC with 426 (62%) females and 261 (38%) males, and a mean age of 60.8 +/- 11.1 years --7% for renal cancer, 34% for renal pelvis and ureter cancer, 59% for bladder cancer in the reference population, compared with 6% for renal cancer, 30% for renal pelvis and ureter cancer, 64% for bladder cancer in the ESRD patients. --SIR’s of all UTC, renal cancer, cancer of renal pelvis and ureter, and bladder cancer were 12.9, 11.9, 11.6, and 13.9, respectively. Detail is demonstrated as table 1. Discussions: In ESRD population, UTC is quite different from general population including higher SIR in female and age group among 4th to 6th decades. Cause of this phenomenon can not be clarified in this dataset. may well imply a possible association with the use of Chinese herbs. Conclusion: Female gender, younger age seem related to higher SIR of UTC in ESRD, especially in UT-TCC. This is therefore seen as an issue worthy of further study. Limitation Weakness of this study is the cross-sectional study design and characteristic of the data base. Since to patients I.D are not available, we can not have the pathology report and history of herbal medicine usage. And in some cases we can not calculate the time between diagnosis of ESRD and UTC