Journal
INTERNATIONAL JOURNAL OF CANCER
Volume 148, Issue 1, Pages 67-76Publisher
WILEY
DOI: 10.1002/ijc.33193
Keywords
heterogeneity; prospective cohort study; renal cell carcinoma; risk factors; tumor histology
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The study found that there are different impacts of body mass index (BMI) and smoking on the risk of clear-cell RCC (ccRCC) and papillary RCC (pRCC), while alcohol consumption is negatively associated with the risk of both. Hypertension is positively associated with the risk of both ccRCC and pRCC. The research also indicates significant differences in BMI, BMI change, and smoking duration among current smokers in terms of ccRCC and pRCC risk.
At present, mostly case-control and retrospective studies have investigated the association between etiologic risk factors and the development of histologic subtypes of renal cell carcinoma (RCC). Therefore, we assessed the heterogeneity between body mass index (BMI), cigarette smoking, alcohol consumption and hypertension across clear-cell RCC (ccRCC) and papillary RCC (pRCC) risk in the prospective Netherlands Cohort Study on diet and cancer. In 1986, 120 852 participants aged 55 to 69 completed a self-administered questionnaire on diet and other risk factors for cancer. Participants were followed up for cancer through record linkage. Tumor histology was assessed through centralized revision by two experienced uropathologists. After 20.3 years of follow-up, 384 histologically verified RCC cases, including 315 ccRCC and 46 pRCC cases and 4144 subcohort members were eligible for case-cohort analysis. Hazard ratios and 95% confidence intervals were estimated by multivariable-adjusted proportional hazards models. Overall, BMI was associated positively with ccRCC risk, but inversely with pRCC risk. Cigarette smoking was associated with an increased ccRCC, but a decreased pRCC risk. Alcohol consumption was inversely associated with both ccRCC and pRCC risk. Hypertension was associated with an increased risk of both ccRCC and pRCC. Statistically significant etiologic heterogeneity was observed for BMI, BMI change since age 20, and smoking duration in current smokers across ccRCC and pRCC risk. In conclusion, we observed potential heterogeneity for BMI, BMI change and smoking duration across ccRCC and pRCC risk.
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