Abstract
ObjectivePrevious studies considered the role of occupational causes in kidney cancer but were limited by small sample sizes and imprecise exposure assessment. This study examined the relationship between occupational exposure to asbestos and the risk of kidney cancer across a range of jobs in a large, population-based case-control study in Canada.MethodsData were from the case-control component of the National Enhanced Cancer Surveillance System, a study conducted between 1994 and 1997 in eight Canadian provinces. Male kidney cancer cases, histologically confirmed, and controls completed questionnaires on socio-demographics, anthropometry, diet, smoking, secondhand smoke exposure, and physical activity. Occupational histories were also collected, including each job held for at least 1 year since the age of 18. Occupational hygienists, blinded to case status, assigned exposure to asbestos, considering intensity, frequency, and probability of exposure (each 3-point scales). Logistic regression was used to estimate the odds of kidney cancer in exposed participants (defined using three metrics) compared to those without asbestos exposure.ResultsThere were 712 cases and 2454 controls in these analyses. Ever-exposure to asbestos was associated with 20% increased odds of kidney cancer compared to unexposed workers (OR 1.2, 95% confidence interval 1.0–1.4 when including possibly exposed workers). A small increase in risk was observed with cumulative exposure, while increasing intensity of exposure was related to increased odds of kidney cancer.ConclusionsThis study found some evidence for an association between occupational exposure to asbestos and kidney cancer. Higher intensity of exposure to asbestos had the strongest relationship with kidney cancer risk.
Highlights
Kidney cancer is the fifth most common cancer among Canadian men (2017), and it occurs at double the incidence in men compared to women (22.3 versus 11.3 cases per 100,000 per year)
We examined whether association estimates varied according to kidney cancer histological subtypes
There was a total of 727 kidney cancer cases (83% renal cell carcinomas) and 2547 controls initially available for these analyses
Summary
Kidney cancer is the fifth most common cancer among Canadian men (2017), and it occurs at double the incidence in men compared to women (22.3 versus 11.3 cases per 100,000 per year) Established risk factors for kidney cancer include cigarette smoking, cystic kidney disease, and features of the metabolic syndrome, which include obesity and hypertension (Kabaria et al 2016). There has long been interest in identifying occupational causes of kidney cancer, but the only established workplace risk factor is trichloroethylene (International Agency for Research on Cancer 2012). Preliminary evidence linking asbestos exposure to increased risk of kidney cancer emerged in the late 1970s; since kidney cancer is relatively rare, there have been few large-scale studies of occupational risk factors (Selikoff et al 1979; Enterline et al 1987). Asbestos is a known cause of lung cancer, mesothelioma, and laryngeal and ovarian cancers (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 2009)
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