Body mass index and other risk factors for kidney cancer in men: a cohort study in Lithuania (original) (raw)
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Hypertension and Obesity and the Risk of Kidney Cancer in 2 Large Cohorts of US Men and Women
Hypertension, 2014
T he incidence of kidney cancer is increasing throughout the world among all age groups, races, and for all tumor sizes. 1,2 Metastatic kidney cancer is one of the most treatment-resistant malignancies with a 5-year relative survival rate of 12.3% at time of diagnosis. 3 Risk factors for kidney cancer include hypertension, increased body weight, and smoking. 4-8 Hypertension has been found to increase risk for kidney cancer in numerous prospective studies. 9-12 However, the duration of follow-up for many of these studies is short. Several studies have lacked measured blood pressure (BP) values. 2,7 The few studies that have included data on women reported increased risk of kidney cancer with higher levels of BP. 2,9,10,13 We previously reported a positive association between BP levels and kidney cancer in men >16 years in the Multiple Risk Factor Intervention Trial (MRFIT). 14 Excess body weight has also been recognized as a risk factor for kidney cancer in general, and specifically in women, 2,15-17 with overweight or obesity estimated to be causally related to >25% of US kidney cancer cases. 5,16 Furthermore, few studies have examined obesity and hypertension together as risk factors for kidney cancer. Obesity is a risk factor for hypertension, thus they may represent a shared causal mechanism. 2 One prospective US study identified a relative risk of 2.82 (95% confidence interval [CI], 1.97-4.02) for all kidney cancer cases in individuals who were both hypertensive and obese when compared with their lean normotensive counterparts. 2 Another analysis, which simultaneously stratified by body mass index (BMI) and BP categories, found that BMI showed only a nonsignificant effect on renal cell carcinoma incidence when BP was markedly elevated. 10 We examined the relationship between levels of hypertension and degree of obesity as risk factors for kidney cancer both separately and in relationship to one another over 10.8 years in a large racially diverse female population. We complemented these analyses with an evaluation of the long-term associations among BP, cigarette smoking, and kidney cancerspecific mortality in men, examining 25 years of follow-up in the 353 340 men screened for the MRFIT. 18 Abstract-Kidney cancer incidence is increasing globally. Reasons for this rise are unclear but could relate to obesity and hypertension. We analyzed longitudinal relationships between hypertension and obesity and kidney cancer incidence in 156 774 participants of the Women's Health Initiative clinical trials and observational studies over 10.8 years. In addition, we examined the effect of blood pressure (BP) on kidney cancer deaths for over 25 years among the 353 340 men screened for the Multiple Risk Factor Intervention Trial (MRFIT). In the Women's Health Initiative, systolic BP (SBP) was categorized in 6 groups from <120 to >160 mm Hg, and body mass index was categorized using standard criteria. In ageadjusted analyses, kidney cancer risk increased across SBP categories (P value for trend <0.0001) and body mass index categories (P value for trend <0.0001). In adjusted Cox proportional hazards models, both SBP levels and body mass index were predictors of kidney cancer. In the MRFIT sample, there were 906 deaths after an average of 25 years of follow-up attributed to kidney cancer among the 353 340 participants aged 35 to 57 years at screening. The risk of death from kidney cancer increased in a dose-response fashion with increasing SBP (hazard ratio, 1.87 for SBP>160 versus <120 mm Hg; 95% confidence interval, 1.38-2.53). Risk was increased among cigarette smokers. Further research is needed to determine the pathophysiologic basis of relationships between both higher BP and the risk of kidney cancer, and whether specific drug therapies for hypertension can reduce kidney cancer risk.
Obesity and kidney cancer risk in men: a meta-analysis (1992-2008)
Asian Pacific journal of cancer prevention : APJCP
We conducted a quantitative summary analysis to evaluate the recent evidence of kidney cancer risk according to body mass index (BMI) among men. The studies included in this quantitative review were all cohort and case-control studies, which provided information on kidney cancer risk associated with obesity/overweight, published between 1992 and 2008. The details of studies have been identified through searches on the MEDLINE database. We first estimated the risk associated with a unit increase in BMI (1 kg/m(2)) for individual studies using logit-linear model. After deriving the natural logarithm of the risk per unit of BMI for all studies, we calculated a pooled estimate and corresponding 95% confidence interval (CI) as a weighted average of the risk obtained in individual studies, by giving a weight proportional to its precision. A total of 27 studies (13 cohort studies and 14 case-control studies) that provided kidney cancer risk according to BMI in men were included in the pres...
Cancer Causes & Control, 2005
Objective: We prospectively investigated the independent association of hypertension, thiazide use, body mass index, weight change, and smoking with the risk of renal cell carcinoma among men and women using biennial mailed questionnaires. Methods: The study population included 118,191 women participating in the Nurses' Health Study and 48,953 men participating in the Health Professionals Follow-up Study Results: During 24 years of follow-up for women and 12 years for men, 155 and 110 incident cases of renal cell carcinoma were confirmed, respectively. In multivariate models including age, body mass index (BMI), smoking and hypertension, higher BMI was confirmed as a risk factor for women and smoking as a risk factor for men and women. After adjusting for age, updated BMI and smoking, an updated diagnosis of hypertension was associated with renal cell carcinoma (RCC); the relatve risk (RR) was 1.9 (95% CI 1.4-2.7) for women and 1.8 (95% CI 1.2-2.7) for men. Based on limited data regarding the use of thiazide diuretics, we did not observe a risk associated with their use, independent of the diagnosis of hypertension. Conclusions: Diagnosis of hypertension, higher BMI, and increasing pack-years of smoking appear to independently increase the risk of renal cell carcinoma.
Body Mass Index and Renal Cell Cancer
Epidemiology, 2012
Background-Obesity is a risk factor for renal cell (or renal) cancer. The increasing prevalence of obesity may be contributing to the rising incidence of this cancer over the past several decades. The effects of early-age obesity and change in body mass index (BMI) on renal cancer have been studied less thoroughly, and the influence of race has never been formally investigated. Methods-Using data gathered as part of a large case-control study of renal cancer (1,214 cases and 1,234 controls), we investigated associations with BMI at several time points, as well as with height. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using logistic regression modeling. Race-and sex-stratified analyses were conducted to evaluate subgroup differences. Results-Obesity (BMI ≥ 30 kg/m 2) early in adulthood (OR=1.6 [95% CI=1.1 to 2.4]) and 5 years before diagnosis (1.6 [1.1 to 2.2]) was associated with renal cancer. The association with early-adult obesity was stronger among whites than blacks (Test for interaction, P=0.006), while the association with obesity near diagnosis was marginally stronger in women than men (Test for interaction, P=0.08). The strongest association with renal cancer was observed for obese whites both in early adulthood and prior to interview (2.6 [1.5 to 4.4]); this association was not present among blacks. Estimates of the annual excess rate of renal cancer (per 100,000 persons) attributed to both overweight and obesity (BMI > 25 kg/m 2) ranged from 9.9 among black men to 5.6 among white women. Conclusion-Obesity, both early and later in life, is associated with an increased risk of renal cancer. The association with early obesity appears to be stronger among whites than blacks.
Obesity and hypertension interact to increase risk of renal cell carcinoma in Iowa, USA
Obesity research & clinical practice, 2007
Renal cell carcinoma (RCC) rates in the US have risen, along with those of obesity and hypertension. We investigated the interactive relationship with obesity and hypertension (HT) through a population-based case-control study of RCC in Iowa consisting of 406 cases and 2434 controls. Data on height and weight at various ages and history of HT were collected and interaction tested by log-likelihood ratio tests. After adjustment, both obesity and HT were independently and interactively associated with increased RCC risk. Hypertensive subjects, obese (BMI ≥ 30) at age 40 were 4.2 (CI: 2.38-6.53) times more likely to develop RCC as normotensive individuals of normal weight (BMI < 25). A similar interactive pattern was observed for obesity at age 60 (p = 0.02). Interaction with obesity was more evident in women (pinteraction = 0.04 age 40, pinteraction = 0.01 age 60). Our findings suggest that maintaining body weight and/or controlling HT are strategies for preventing RCC.:
American Journal of Epidemiology, 2004
A positive association between body mass index (BMI) and renal cell carcinoma (RCC) has been observed. The association between height and RCC has been less clear. The authors explored these relations in a very large Norwegian cohort. Height and weight were measured in two million Norwegian men and women aged 20-74 years during 1963-2001. During follow-up, 6,453 cases of RCC were registered in the national cancer database. Measurements were also performed in 227,000 adolescents aged 14-19 years, and 154 cases of RCC were registered. Relative risks for RCC were estimated using Cox proportional hazards regression. The risk of RCC increased with increasing BMI among both adults and adolescents. Among adults, the relative risk associated with a one-unit increase in BMI was 1.05 (95% confidence interval (CI): 1.04, 1.06) in both sexes. The relative risk associated with a 10-cm increase in height was 1.19 (95% CI: 1.13, 1.26) in men and 1.17 (95% CI: 1.09, 1.26) in women. In a subgroup analysis, the relation between BMI and RCC was most pronounced in men and women who were never smokers, and the relation between height and RCC was confined to ever smokers. The authors conclude that elevated BMIs are associated with RCC risk in both males and females across a wide age range.
Risk Factors for Renal Cell Cancer: The Multiethnic Cohort
The association of body size, lifestyle, and medical conditions with renal cell cancer risk was examined among 161,126 Hawaii-Los Angeles Multiethnic Cohort participants (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002). After 8.3 years of follow-up, 347 renal cell cancer cases (220 men, 127 women) were identified. Renal cell cancer risk increased with increasing body mass index in men (multivariate relative risk (RR) ¼ 1.06 per unit of body mass index, p ¼ 0.001) and women (RR ¼ 1.07, p < 0.0001). The relative risks associated with being obese compared with being lean were 1.76 (95% confidence interval (CI): 1.20, 2.58) for men and 2.27 (95% CI: 1.37, 3.74) for women. Hypertension was associated with renal cell cancer (RR men ¼ 1.42, 95% CI: 1.07, 1.87; RR women ¼ 1.58, 95% CI: 1.09, 2.28). Smoking was confirmed to be a risk factor for both sexes. Among women, diuretic use was associated with increased risk (RR ¼ 1.63, 95% CI: 1.04, 2.57), whereas physical activity was associated with reduced risk (p trend ¼ 0.027). Alcohol consumption was inversely associated with risk for men (p trend ¼ 0.045). Compared with nondrinkers, men who drank !1 drinks/day had a 31% lower risk (95% CI: 0.49, 0.96). Results show that body mass index, smoking, and hypertension are risk factors for renal cell cancer in both sexes.