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

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.

Fig. 1.

The incidence of renal cell cancer (RCC) by smoking status. The curves represent the risk of RCC (0–1) in each group adjusting for the average effects of hypertension, education, treatment arm, body mass index, race, family history, and diabetic status.

Fig. 2.

The incidence of renal cell cancer (RCC) by hypertension status. The curves represent the risk of RCC (0–1) in each group adjusting for the average effects of smoking, education, treatment arm, body mass index, race, family history, and diabetic status.

Fig. 3.

The incidence of renal cell cancer (RCC) by body mass index. The curves represent the risk of RCC (0–1) in each group adjusting for the average effects of hypertension, smoking, education, treatment arm, race, family history, and diabetic status.