Abstract
While overweight among adults has been linked with renal cell carcinoma (RCC) risk, little is known about the potential influence of overweight and obesity during adolescence. To ascertain if adolescent body mass index is associated with subsequent risk of RCC, we identified a cohort of 238,788 Swedish men who underwent mandatory military conscription assessment between 1969 and 1976 at a mean age of 18.5 years. At the time of conscription assessment, physical and psychological tests were performed including measurements of height and weight. Participants were followed through linkage to the Swedish Cancer Registry to identify incident diagnoses of RCC. The association between body mass index (BMI, kg/m2) at conscription assessment and subsequent RCC was evaluated using multivariable Cox regression. During a follow‐up of up to 37 years, 266 men were diagnosed with RCC. We observed a trend for higher RCC risk with increasing BMI during adolescence, where one‐unit increase in BMI conferred a 6% increased risk of RCC (95% CI 1.01–1.10). compared to normal weight men (BMI 18.5‐ < 25), men with overweight (BMI 25‐ < 30) or obesity (BMI ≥30) had hazard ratios for RCC of 1.76 (95% CI 1.16–2.67) and 2.87 (95% CI 1.26–6.25), respectively. The link between overweight/obesity and RCC appear to be already established during late adolescence. Prevention of unhealthy weight gain during childhood and adolescence may thus be a target in efforts to decrease the burden of RCC in the adult population.
Highlights
The incidence of renal cell carcinoma (RCC) has increased globally over recent decades, and the underlying reasons are not well understood
What’s new? While overweight among adults has been linked with renal cell carcinoma risk, little is known about the potential influence of overweight and obesity during adolescence
This large prospective cohort study over more than 35 years suggests that the link between overweight/obesity—alone and in combination with low physical working capacity—and renal cell carcinoma is already established in late adolescence
Summary
The incidence of renal cell carcinoma (RCC) has increased globally over recent decades, and the underlying reasons are not well understood. RCC accounts for more than 90% of all renal malignancies and a total of 338,000 new cases leads to over 140,000 deaths annually.[1]. Obesity is a well-established risk factor for RCC in both men and women,[4] but most studies have focused on adults.[5–7]. The prevalence of obesity among teenagers has increased dramatically over recent decades,[8] but few studies have yet addressed the potential influence of overweight and obesity in adolescence on RCC risk. An important role for inflammation in tumorigenesis is generally accepted and an inflammatory microenvironment is considered an essential component of all tumours.[9]. Obesity is considered a state of chronic low-grade systemic inflammation through activation of acute-phase and systemic inflammatory response proteins.[10].
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