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No AccessJournal of UrologyAdult Urology1 Nov 2013

Risk Factors for Renal Cell Carcinoma in the VITAL Study

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    The incidence of renal cell carcinoma is increasing worldwide. Cited risk factors include obesity, smoking and hypertension but few others have been confirmed in prospective studies. We used a prospective cohort to validate established renal cell carcinoma risk factors and evaluate more controversial risk factors for incident renal cell carcinoma.

    Materials and Methods:

    A total of 77,260 residents of Washington 50 to 76 years old completed a questionnaire between 2000 and 2002 on demographic, lifestyle and health data. Incident renal cell carcinoma cases were determined by linkage to the regional cancer registry through December 31, 2009. Multivariate methods using covariates and cutoffs selected a priori were applied to analyze the association between renal cell carcinoma and previously studied factors related to lifestyle (body mass index, smoking and alcohol/fruit/vegetable consumption) and health (hypertension, diabetes, kidney disease and viral hepatitis).


    There were 249 incident cases of renal cell carcinoma. Independent renal cell carcinoma risk factors in the fully adjusted model were body mass index (35 or greater vs less than 25 kg/m2 HR 1.71, 95% CI 1.06–2.79), smoking (greater than 37.5 pack-years vs never HR 1.58, 95% CI 1.09–2.29), hypertension (HR 1.70, 95% CI 1.30–2.22), kidney disease (HR 2.58, 95% CI 1.21–5.50) and viral hepatitis (HR 1.80, 95% CI 1.03–3.14). Diabetes was associated with renal cell carcinoma (HR 1.83, 95% CI 1.26–2.65) in a base model adjusting for age and gender but not in the multivariate model. We found no association between alcohol, fruit or vegetable intake and renal cell carcinoma.


    We identified a significant association of renal cell carcinoma with obesity, smoking, hypertension, renal disease and viral hepatitis. Identifying risk factors offers an opportunity for targeted education and intervention.


    • 1 SEER Stat Fact Sheets: Kidney and Renal Pelvis. Bethesda: National Cancer Institute2011. Google Scholar
    • 2 : GLOBOCAN 2008: Estimated Cancer Incidence and Mortality Worldwide. IARC CancerBase No. 10. Lyon: International Agency for Research on Cancer 20082012. Google Scholar
    • 3 : Environmental and modifiable risk factors in renal cell carcinoma. Urol Oncol2012; 30: 220. Google Scholar
    • 4 : Contemporary epidemiology of renal cell carcinoma: perspectives of primary prevention. World J Urol2010; 28: 247. Google Scholar
    • 5 : Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med2000; 343: 1305. Google Scholar
    • 6 : Blood pressure and risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition. Am J Epidemiol2008; 167: 438. Google Scholar
    • 7 : Smoking, environmental tobacco smoke, and risk of renal cell cancer: a population-based case-control study. BMC Cancer2008; 8: 387. Google Scholar
    • 8 : Renal cell carcinoma in relation to cigarette smoking: meta-analysis of 24 studies. Int J Cancer2005; 114: 101. Google Scholar
    • 9 : Body size and renal cell cancer incidence in a large US cohort study. Am J Epidemiol2008; 168: 268. Google Scholar
    • 10 : Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer2006; 118: 728. Google Scholar
    • 11 : VITamins and Lifestyle cohort study: study design and characteristics of supplement users. Am J Epidemiol2004; 159: 83. Google Scholar
    • 12 : Not all fat is equal: differential gene expression and potential therapeutic targets in subcutaneous adipose, visceral adipose, and endometrium of obese women with and without endometrial cancer. Int J Gynecol Cancer2012; 22: 732. Google Scholar
    • 13 : Differentially expressed genes in visceral or subcutaneous adipose tissue of obese men and women. J Lipid Res2004; 45: 148. Google Scholar
    • 14 : Risk factors for renal cell cancer: the multiethnic cohort. Am J Epidemiol2007; 166: 932. Google Scholar
    • 15 : Prospective study of alcohol drinking and renal cell cancer risk in a cohort of Finnish male smokers. Cancer Epidemiol Biomarkers Prev2005; 14: 170. Google Scholar
    • 16 : Intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and risk of renal cell cancer. Cancer Epidemiol Biomarkers Prev2006; 15: 2445. Google Scholar
    • 17 : Fruits and vegetables and renal cell carcinoma: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer2006; 118: 3133. Google Scholar
    • 18 : Risk for renal cell carcinoma in chronic hepatitis C infection. Cancer Epidemiol Biomarkers Prev2010; 19: 1066. Google Scholar
    • 19 : The core protein of hepatitis C virus induces hepatocellular carcinoma in transgenic mice. Nat Med1998; 4: 1065. Google Scholar
    • 20 : Hepatitis C virus RNA and core protein in kidney glomerular and tubular structures isolated with laser capture microdissection. Clin Exp Immunol2005; 140: 498. Google Scholar
    • 21 : Renal cell carcinoma and hepatitis C virus infection: is there any cause-outcome relationship?. J Cancer Res Ther2011; 7: 226. Google Scholar
    • 22 : Association of hepatitis C seropositivity with increased risk for developing end-stage renal disease. Arch Intern Med2007; 167: 1271. Google Scholar
    • 23 : Prevalence of acquired cystic kidney disease and tumors in native kidneys of renal transplant recipients: a prospective US study. Radiology1995; 195: 667. Google Scholar
    • 24 : Renal cell carcinoma in kidney transplant recipients and dialysis patients. Korean J Urol2012; 53: 229. Google Scholar
    • 25 : Renal cystic diseases and renal neoplasms: a mini-review. Clin J Am Soc Nephrol2009; 4: 1998. Google Scholar
    • 26 : Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure. Urology2009; 74: 631. Google Scholar
    • 27 : Renal cell carcinoma in autosomal dominant polycystic kidney disease. J Am Soc Nephrol1994; 4: 1661. Google Scholar
    • 28 : Type 2 diabetes and the risk of renal cell cancer in women. Diabetes Care2011; 34: 1552. Google Scholar