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Purpose: This study investigated metabolic health status as a risk factor for female bladder cancer using the National Health Checkups databases of Korea.Materials and Methods: We defined obesity if body mass index was ≥25 kg/m 2  and normal weight as  2 . Metabolic unhealthiness was defined when 3 or more criteria of metabolic syndrome were met. A total of 11,461,618 women who took National health Checkups between 2009 and 2012 were categorized as metabolic healthy normal weight (MHNW), metabolic unhealthy normal weight (MuHNW), metabolic health obese (MHO), and metabolic unhealthy obese (MuHO). Multivariable-adjusted Cox regression was done to analyze the hazard ratio of bladder cancer.Results: The mean age was 48±11.55 years and body mass index was 23.19±2.13 kg/m 2 . During 5.4±1.1 years of follow-up, 3,893 patients were newly diagnosed with bladder cancer. Compared to MHNW group, the hazard ratio of MuHNW group and MuHO group were 1.237 and 1.288, respectively, while 0.997 in the MHO group. As the number of metabolic unhealthy criteria increased, the cumulative incidence of bladder cancer increased.Conclusions: As a result of a large-scale study conducted on the female population in Korea, the risk of bladder cancer increased with metabolic unhealthiness. Even with normal weight, if metabolically unhealthy, the risk of bladder cancer increased. The greater the degree of metabolic unhealthiness, the higher the risk of bladder cancer. Education on metabolic healthiness concerning female bladder cancer is necessary.

A Study on Metabolic Health Status as a Risk Factor for Female Bladder Cancer Incidence: Analysis From the National Health Checkups Database of Korea