Abstract
BackgroundKidney and renal pelvis cancers account for 4% of all new cancer cases in the United States, among which 85% are renal cell carcinomas (RCC). While cigarette smoking is an established risk factor for RCC, little is known about the contribution of environmental tobacco smoke (ETS) to RCC incidence. This study assesses the role of smoking and ETS on RCC incidence using a population-based case-control design in Florida and Georgia.MethodsIncident cases (n = 335) were identified from hospital records and the Florida cancer registry, and population controls (n = 337) frequency-matched by age (+/- 5 years), gender, and race were identified through random-digit dialing. In-person interviews assessed smoking history and lifetime exposure to ETS at home, work, and public spaces. Home ETS was measured in both years and hours of exposure. Odds ratios and 95% confidence intervals were calculated using logistic regression, controlled for age, gender, race, and BMI.ResultsCases were more likely to have smoked 20 or more pack-years, compared with never-smokers (OR: 1.35, 95% CI: 0.93 – 1.95). A protective effect was found for smoking cessation, beginning with 11–20 years of cessation (OR: 0.39, 95% CI: 0.18–0.85) and ending with 51 or more years of cessation (OR: 0.11, 95% CI: 0.03–0.39) in comparison with those having quit for 1–10 years. Among never-smokers, cases were more likely to report home ETS exposure of greater than 20 years, compared with those never exposed to home ETS (OR: 2.18; 95% CI: 1.14–4.18). Home ETS associations were comparable when measured in lifetime hours of exposure, with cases more likely to report 30,000 or more hours of home ETS exposure (OR: 2.37; 95% CI: 1.20–4.69). Highest quartiles of combined home/work ETS exposure among never-smokers, especially with public ETS exposure, increased RCC risk by 2 to 4 times.ConclusionThese findings confirm known associations between smoking and RCC and establish a potential etiologic role for ETS, particularly in the home. Differences in methods of retrospective measurement of lifetime smoking and ETS exposure may contribute to discrepancies in measures of associations across studies, and should be addressed in future research.
Highlights
Kidney and renal pelvis cancers account for 4% of all new cancer cases in the United States, among which 85% are renal cell carcinomas (RCC)
Kidney and renal pelvis cancers account for nearly 4% of all new cancer cases in the United States, with 54,390 new cases estimated for the year 2008 [1,2]
Compared with healthy Body mass index (BMI) (18.5 – 24.9), being obese (BMI 30 – 39) was associated with an 80% increase in RCC risk for both men (OR = 1.8; 95% confidence interval (CI): 0.9 – 3.6) and women (OR = 1.8; 95% CI: 1.0 – 3.3)
Summary
Kidney and renal pelvis cancers account for 4% of all new cancer cases in the United States, among which 85% are renal cell carcinomas (RCC). Incidence rates have almost doubled over the past 30 years – from 7.1 per 100,000 in 1975 to 13.4 per 100,000 in 2005 [1] Most of these cases are renal cell carcinomas (RCC), accounting for approximately 85% of all renal tumors [3]. In a recent meta-analysis, ever-smoking produced a relative risk for RCC of 1.38, and risk increases were generally greater among men (RR = 1.50) than women (RR = 1.27) [4] Despite these modest risk increases, dose-response associations and cessation effects have been consistently reported. The International Agency for Research on Cancer has concluded that sufficient evidence exists for a causal association between cigarette smoking and RCC [5]
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