PTU - Polskie Towarzystwo Urologiczne
list of articles:

Renal cell carcinoma risk factors
Article published in Urologia Polska 2005/58/3.

authors

Ivan Kawaciuk, Lubomír Hyršl, Pavel Dušek, Ladislav Jarolím, Marek Schmidt, Veronika Kaliská, Matúš Chocholatý, Markéta Urbanová
Department of Urology, 2nd Faculty of Medicine, Faculty Hospital in Motol, Prague, Czech Republic
Head of the Department: Assoc. prof. Ivan Kawaciuk, MD, Ph.D.

keywords

renal cell carcinoma, pathogenesis, risk factors, smoking, obesity, hypertension

summary

The aim of the study.
Evaluation of risk factors incidence, especially smoking, obesity and hypertension, in our group of long-term observed patients with renal cell carcinoma (RCC) in comparison to group of hypothetic population frequency-matched on age and sex.
Materials and methods.
Patients' group consisted of 316 consecutive patients operated for RCC between 1982 and 1998 at our institution. Hypothetic population group was created from the data of Institute of Health Information and Statistics of the Czech Republic. As heavy smokers were identified people smoking over 20 or more cigarettes per day and as obese people with body mass index (BMI) ł 35 kg/m2. Incidence of risk factors was analysed in both groups by log-rank test.
Results.
In comparison to selected population there was significantly higher incidence of heavy smokers (20.6 vs. 5,9%; p <0.01) and obese people (12.7 vs. 4.3%; p <0.01) in the patients' group. There was no significant difference (36.1 vs. 33.3 %; p = 0.22) in the occurrence of hypertension. Other risk factors were noticed rarely. Six patients (1.9%) had alcohol abuse problems, four (1.3%) had radiotherapy of retroperitoneum for other malignancies in their history, four (1.3 %) had polycystic kidney disease and three (0.9%) had end-stage renal disease. Seven percent had a malignant duplicity which was diagnosed prior to RCC and 15.8% (50/316) had malignant tumor in their family history.
Conclusions.
Results of our retrospective study confirmed previously published data about significantly increased risk of renal cell carcinoma in relation to tobacco smoking and elevated BMI.

references

  1. Bennington JL: Cancer of the kidney - etiology, epidemiology and pathology. Cancer 1973; 32; 1017-1029.
  2. Arison RN, Feudale EL: Induction of renal tumour by streptozotocin in rats. Nature 1967; 214; 1254-1255.
  3. Epstein SM, Bartus B, Farber E: Renal epithelial neoplasms induced in male Wistar rats by oral aflatoxin B 1. Cancer Res 1969; 29; 1045-1046.
  4. Kirkman H: Estrogen-induced tumors of the kidney in the Syrian hamsters. Natl Cancer Inst Monogr 1959; 1; 1-139.
  5. Dhôte R, Pellicer-Coeuret M, Thioun A, Debre B, Vidal-Trecan G: Risk factors for adult renal cell carcinoma. A systemic review and implications for prevention. BJU Int 2000; 86; 20-27.
  6. Hu J, Mao Y, White K: Renal cell carcinoma and occupational exposure to chemicals in Canada. Occup Med (Lond) 2002; 52; 157-164.
  7. ÚZIS ČR: Výběrové šetření o zdravotním stavu české populace 2002. Praha, ÚZIS ČR, 2003.
  8. Godley PA, Ataga KI: Renal cell carcinoma. Curr Opin Oncol 2000; 12; 260-264.
  9. La Vecchia C, Negri E, D?Avanzo B, Franceschi S: Smoking and renal cell carcinoma. Cancer Res 1990; 50; 5231-5233.
  10. McLaughlin JK, Lindblad P, Mellemgaard A, et al: International renal cell cancer study: I. Tobacco use. Int J Cancer 1995; 60; 194-198.
  11. Goodman MT, Morgenstern H, Wynder EL: A case-control study of factors affecting the development of renal cell cancer. Am J Epidemiol 1986; 124; 926-941.
  12. Bennigton JL, Laubscher FA: Epidemiologic studies on carcinoma of the kidney: I. Association of renal adenocarcinoma with smoking. Cancer 1968; 21; 1069-1071.
  13. Muscat JE, Hoffmann D, Wynder EL: The epidemiology of renal cell carcinoma: A second look. Cancer 1995; 75; 2552-2557.
  14. Parker AS, Cerhan JR, Janney CA, Lynch CF, Cantor KP: Smoking cessation and renal cell carcinoma. Ann Epidemiol 2003; 13; 245-251.
  15. Parker A, Freeman LB, Cantor K, Lynch C: Self-report of smoking, obesity and hypertension history and survival among a cohort of Iowa renal cell carcinoma cases. Ann Epidemiol 2000; 10; 467-468.
  16. Liehr JG: Hormone-associated cancer: mechanistic similarities between human breast cancer and estrogen-induced kidney carcinogenesis in hamsters. Environ Health Perspect 1997; 105 (S3); 565-569.
  17. Muscat JE: The epidemiology of renal cell cancer; in Bukowski RM, Novick AC, (eds): Renal cell carcinoma. Totowa (NJ), Human Press, 2000: 3-14.
  18. Yuan JM, Castelao JE, Gago-Dominguez M, Ross RK, Yu MC: Hypertension, obesity and their medications in relation to renal cell carcinoma. J Cancer 1998; 77; 1508-1513.
  19. Yu ML, Asal NR, Geyer JR: Later recurrence and longer survival among obese patients with renal cell carcioma. Cancer 1991; 68; 1648-1655.
  20. Kamat AM, Shock RP, Naya Y, Rosser CJ, Slaton JW, Pisters LL: Prognostic value of body mass index in patients undergoing nephrectomy for localized renal tumors. Urology 2004; 63; 46-50.
  21. Shapiro JA, Williams MA, Weiss NS, Stergachis A, LaCroix AZ, Barlow WE: Hypertension, antihypertensive medication use, and risk of renal cell carcinoma. Am J Epidemiol 1999; 149; 521-530.
  22. Chow WH, Devesa SS, Warren JL, et al. Epidemiology of renal cell carcinoma; in Vogelzang N, Scardino PT, Shipley WU, et al. (eds): Comprehensive textbook of genitourinary oncology. Philadelphia, Lippincott Williams & Wilkins, 2000: 1011-1015.
  23. Grossman E, Messerli FH, Boyko V, Goldbourt U: Is there an association between hypertension and cancer mortality? Am J Med 2002; 112; 479-486.
  24. Vogelzang NJ, Yang X, Goldman S, Vijayakumar S, Steinberg G: Radiation induced renal cell cancer: A report of 4 cases and review of the literature. J Urol 1998; 160; 1987-1990.
  25. Ishikawa I, Saito Y, Shikura N, Kitada H, Shinoda A, Suzuki S: A ten-year prospective study on the development of renal cell carcinoma in dialysis patients. Am J Kidney Disease 1990; 16; 452-458.
  26. Maru N, Iwamura M, Ishii J, et al. The clinicopathological characteristics in renal cell carcinoma with end-stage renal disease. Nippon Hinyokika Gakkai Zasshi 2003; 94; 434-438.
  27. Hanley AJ, Choi BC, Holoway EJ. Cancer mortality among Chinese migrants: a review. Int J Epidemiol 1995; 24: 255-265.
  28. Godley PA, Stinchcombe TE. Renal cell carcinoma. Curr Opin Oncol 1999; 11; 213-217.
  29. Lindblad P, Wolk A, Bergstrom R, Adami HO: Diet and risk of renal cell cancer: A population-based case-control study. Cancer Epidemiol Biomarkers Prev 1997; 6; 215-223.

correspondence

Ivan Kawaciuk
Department of Urology, Charles University in Prague
2nd Faculty of Medicine and Faculty Hospital in Motol
V Uvalu 84,
150 06 Praha 5, Czech Republic
Phone +420-22443 4800; Fax 22443 4820
ivan.kawaciuk@lfmotol.cuni.cz