Abstract
Objective: To identify the validity of established western risk factors in renal cell carcinoma in Sri Lanka. Design, setting and methods: A case control study was designed to compare 36 consecutive, renal cell carcinoma (RCC) cases treated at one urology unit of a tertiary referral centre with 72 age, sex matched controls. Well studied risk factors in western countries such as smoking, hypertension, obesity, occupational chemical exposure and use of long term analgesics were included. Data was analyzed with standard matched pair methods. Conditional logistic regression models were used to examine the univariate and multivariate relationships of RCC with various risk factors. Results: There were 28 males and 08 females. Mean age at diagnosis was 56.92 (27-83) years. Obesity (BMI ≥ 30 kg/m2) increased the risk of RCC by 6 folds in comparison to BMI less than 25. Positive occupational exposure was shown to increase the risk of RCC by 3.2 folds (CI = 1.2-8.5) and hypertension by 4.1 folds (95%CI 1.09 - 15.39) after making adjustments for co-founding factors. Interestingly amount of smoking calculated in pack years showed an increasing trend in the odds ratio suggesting increase risk of RCC with smoking, but failed to show a strong association in the univariate analysis. Conclusions: Comparing to the results of western studies present smoking state didn't show a strong positive correlation as a risk factor. However, increasing pack years demonstrated an increased risk. Hypertension, obesity and occupational chemical exposure were shown to increase the risk as found in the west. Other factors such as analgesics, alcohol and social class did not demonstrate a significant correlation. DOI: 10.4038/sljs.v27i2.2098 The Sri Lanka Journal of Surgery 2009: 27: 39-44
Highlights
Renal cell carcinoma (RCC) which commonly originates from proximal renal tubular epithelium accounts for approximately 3% all cancers of adults and 85% of all primary malignant tumours of the kidney [1]
Positive occupational exposure was shown to increase the risk of RCC by 3.2 folds (CI = 1.2-8.5) and hypertension by 4.1 folds (95%CI 1.09 - 15.39) after making adjustments for co-founding factors
Amount of smoking calculated in pack years showed an increasing trend in the odds ratio suggesting increase risk of RCC with smoking, but failed to show a strong association in the univariate analysis
Summary
Renal cell carcinoma (RCC) which commonly originates from proximal renal tubular epithelium accounts for approximately 3% all cancers of adults and 85% of all primary malignant tumours of the kidney [1]. It is characterized by a lack of early warning signs, diverse clinical manifestations, and resistance to radiation and chemotherapy. The risk factors which are studied in the west and rest of the world literature includes its genetic predisposition, tobacco usage, hypertension, obesity and occupational exposures to carcinogens such as heavy metals, petroleum products and asbestos. As there are hardly any published data on this subject in south Asia this study was designed to test the validity of these findings in this region
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