Table 2 Matrix for assessing the risk factors for the causal relationships between spinal cord injury and bladder cancer
From: Urinary bladder cancer as a late sequela of traumatic spinal cord injury
Indicators | Value of the arguments | |||||
|---|---|---|---|---|---|---|
Recognition impossible | Strong counter argument | Weak counter argument | Neutral | Weak pro-argument | Strong pro-argument | |
Tumour characteristics | ||||||
Early onset of bladder cancer (compared with onset in the general population) | – | – | 0 years | 1–10 years | 11–20 years | > 20 years |
Latency period (paralysis duration) | < 5 years | – | 5–10 years | – | ≥11 years | – |
Tumour extent (T category) at initial diagnosis | – | – | – | Tis, Ta, T1 | ≥ T2 | – |
Tumour type | – | – | – | Transitional cell carcinoma, low grade | Transitional cell carcinoma, high grade or other tumour types | Squamous cell carcinoma |
Medical treatment | ||||||
Permanent catheter (indwelling catheter, suprapubic catheter) | – | – | – | No catheter | < 5 years | > 5 years |
Radiotherapy cervix cancer | – | > 30 years ago | 10–30 years ago | < 10 years ago | – | – |
Radiotherapy prostate cancer, rectal cancer | – | – | – | yes | – | – |
Cyclophosphamide treatment (total dose) | – | ≥ 50 g | 20–49 g | < 20 g | – | – |
Smoking habits | ||||||
Never-smoker | – | – | – | – | Yes | – |
Smoker till onset of bladder cancer | – | ≥ 30 py | 10–29 py | < 10 py | – | – |
Ex-smoker for 1–9 years | – | ≥ 45 py | 14–44 py | < 14 py | – | – |
Ex-smoker for 10–19 years | – | ≥ 45 py | 24–44 py | < 24 py | – | – |
Ex-smoker for 20–24 years | – | ≥ 70 py | 25–69 py | < 25 py | – | – |
Ex-smoker for ≥25 years | – | – | – | Yes | – | – |
Spinal cord injury related factors | ||||||
Type of bladder paralysis | – | – | – | UMNL, LMNL | – | – |
Urinary tract infections | – | – | – | Yes, regardless of frequency | – | – |
Bladder stones | – | – | – | Yes | – | – |