Abstract
To determine whether higher coffee intake may reduce the risk of renal cell cancer (RCC) associated with lead (Pb) and other heavy metals with known renal toxicity. We conducted a nested case-control study of male smokers (136 RCC cases and 304 controls) within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Cases diagnosed with RCC at 5 or more years following cohort enrollment were matched to controls on age (± 7years) and whole blood draw date (± 30days). Conditional logistic regression (using two-sided tests) was used to test for main effects and additive models of effect modification. After a mean follow-up of 16.3years, coffee consumption was not significantly associated with renal cell cancer risk, when adjusting for blood concentrations of Cd, Hg, and Pb and RCC risk factors (age, smoking, BMI, and systolic blood pressure) (p-trend, 0.134). The association with above median blood Pb and RCC (HR = 1.69, 95% CI 1.06, 2.85) appeared to be modified by coffee consumption, such that RCC risk among individuals with both increased coffee intake and higher blood lead concentration were more than threefold higher RCC risk (HR = 3.40, 95% CI 1.62, 7.13; p-trend, 0.003). Contrary to our initial hypothesis, this study suggests that heavy coffee consumption may increase the previously identified association between higher circulating lead (Pb) concentrations and increased RCC risk. Improved assessment of exposure, including potential trace element contaminants in coffee, is needed.
Highlights
Well-established risk factors for renal cell cancer (RCC) include cigarette smoking, elevated blood pressure, and obesity–explaining approximately half of all cases [1]
Contrary to our initial hypothesis, this study suggests that heavy coffee consumption may increase the previously identified association between higher circulating lead (Pb) concentrations and increased RCC risk
Among the risk factors we investigated, the greatest positive bivariate correlations were observed between number of cigarettes per day and whole blood Cd, and cigarettes per day and coffee consumption (g/day); the greatest negative correlation observed was between cigarettes per day and age (Supplemental Table 1)
Summary
Well-established risk factors for renal cell cancer (RCC) include cigarette smoking, elevated blood pressure, and obesity–explaining approximately half of all cases [1]. Nearly every country has reported increases in the age-adjusted incidence of RCC over the past decade, despite relatively constant population prevalence rates of obesity, smoking and hypertension, and a greater than two-fold increase in the prevalence of controlled hypertension in some countries [50]. Taken together, this suggests the need to identify additional factors for improved RCC prevention.
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