Modifiable risk factors to reduce renal cell carcinoma incidence: Insight from the PLCO trial

Urol Oncol. 2018 Jul;36(7):340.e1-340.e6. doi: 10.1016/j.urolonc.2018.04.011. Epub 2018 May 17.

Abstract

Introduction: Identify modifiable factors contributing to renal cell carcinoma in the PCLO to target disease prevention and reduce health care costs.

Methods: The prostate, lung, colorectal, and ovarian database were queried for the primary outcome of kidney cancer. Demographics were investigated, specifically focusing on modifiable risk factors. Statistical analysis includes the Student t-test for continuous variables, chi-squared or Fisher's exact tests for dichotomous and categorical variables for bivariate analysis. The Cox proportional hazards model was used in a multivariate time-to-event analysis.

Results: We investigate existing data relating specifically to renal cancer. After missing data were excluded, we analyzed 149,683 subjects enrolled in the prostate, lung, colorectal, and ovarian trial and noted 0.5% (n = 748) subjects developed renal cancer. Age, male gender, body mass index, diabetes, and hypertension were all significant associated with renal cancer in bivariate analysis (P<0.05). Men have a significant increased risk of kidney cancer over women (hazard ratio [HR] = 1.85; 95% CI: 1.58-2.16; P<0.0001). Nonmodifiable risk factors that are associated with kidney cancer include age (HR = 1.05; 95% CI: 1.01; 1.05, P = 0.001). Modifiable risk factors include obesity measured by body mass index (HR = 1.05; 95% CI: 1.02-1.07; P<0.0001), hypertension (HR = 1.32; 95% CI: 1.13-1.54; P = 0.0004), and smoking in pack-years (HR = 1.04; 95% CI: 1.02-1.07; P = 0.0002).

Conclusions: Obesity, hypertension, and smoking are the 3 modifiable risk factors that could aggressively be targeted to reduce renal cell carcinoma.

Keywords: Blood pressure; Body mass index; Hypertension; Kidney cancer; Lifestyle; Modifiable risk factors; Obesity; Prevention; Renal cancer; Renal cell cancer; Smoking.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / epidemiology
  • Carcinoma, Renal Cell / etiology
  • Carcinoma, Renal Cell / prevention & control*
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension*
  • Incidence
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / etiology
  • Kidney Neoplasms / prevention & control*
  • Lung Neoplasms / complications
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Obesity*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / therapy
  • Prognosis
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / therapy
  • Risk Factors
  • Smoking*
  • United States / epidemiology