Incidence Of Kidney Cancer Research Articles

A Systematic Review and Meta-Analysis of the Significance of Body Mass Index on Kidney Cancer Outcomes.

Obesity is a well-known risk factor for kidney cancer incidence. However, a number of studies have demonstrated more favorable kidney cancer prognosis in patients with elevated body mass index conferring a survival advantage, termed the "obesity paradox." We aimed to evaluate the association between body mass index and kidney cancer outcomes (progression-free survival, cancer specific survival and overall survival). A computerized systematic search of Medline®, Embase®, ProQuest®, PubMed® and Google Scholar™ for literature published in English was performed between its inception and December 2018, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for reporting. Overall, 34 publications comprising a total of 50,717 patients were included in the analysis. The majority assessed the association between body mass index and cancer specific survival. Overweight and obese patients were associated with improved cancer specific survival compared to patients with normal body mass index (HR 0.85, 95% CI 0.79-0.93). A similar trend was demonstrated for progression-free survival (HR 0.68, 95% CI 0.59-0.78) and overall survival (HR 0.66, 95% CI 0.55-0.79). On the contrary, the underweight group was associated with inferior cancer specific survival (HR 2.16, 95% CI 1.15-4.04). Main drawbacks limiting the interpretation were the retrospective design in the majority of studies, heterogeneity in study population, body mass index classification and covariates in multivariate analysis. This is the largest systematic review evaluating the potential phenomenon of the obesity paradox in kidney cancer outcomes. It demonstrated a favorable effect of body mass index on kidney cancer outcomes. However, due to significant heterogeneity of studies, multicenter prospective studies and further research on the fundamental biological mechanisms are warranted to confirm the significance of body mass index on kidney cancer prognosis.

Incidence of Bladder Cancer in Type 2 Diabetes Mellitus Patients: A Population-Based Cohort Study.

Background and objectives: Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide and is associated with increased incidence of kidney cancer and bladder cancer (BC). However, studies have produced conflicting results. Therefore, we retrospectively evaluated the incidence of BC in T2DM patients using the Taiwan National Health Insurance Research Database (NHIRD). Materials and Methods: We included 31,932 patients with a diagnosis of T2DM in the study group and 63,864 age- and sex-matched patients without T2DM at a ratio of 1:2 in the control group. The primary outcome was the diagnosis of BC. Cox proportional hazards regression was used to evaluate the incidence and adjusted hazard ratio (aHR) of BC in the multivariate model. Results: After a 16-year follow-up, we found that 67 BC cases occurred in the study group and 152 BC events in the non-T2DM group without a significantly higher risk (aHR: 0.842, 95% confidence interval: 0.627–1.13). Conclusions: T2DM patients do not have a higher risk of BC.

Diabetes and kidney cancer risk among post-menopausal women: The Iowa women’s health study

BackgroundMany studies have reported a positive association between diabetes and kidney cancer. However, it is unclear whether diabetes is a risk factor for kidney cancer independent of other risk factors, such as obesity and hypertension. We comprehensively examined the association of diabetes and its duration with incident kidney cancer in the prospective cohort Iowa Women’s Health Study (1986–2011). MethodsDiabetes status was self-reported at baseline (1986) and on five follow-up questionnaires. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of baseline and time-dependent diabetes with the risk of incident kidney cancer. ResultsDuring the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975 post-menopausal women. In an age-adjusted model, there was a significant association between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76 (1.26, 1.45)]; the association was attenuated after multivariable adjustment for age, body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity, diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35 (0.94, 1.94)]. However, among non-obese women or women with a waist circumference less than 34.6 in., diabetes was significantly associated with kidney cancer risk: for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with BMI < 30 kg/m2 and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in.. ConclusionsOur results suggest that diabetes is associated with kidney cancer risk among non-obese post-menopausal women.

Kidney cancer: features of distribution and main indicators of specialized care effectiveness

The paper presents an analysis of official statistics on the incidence and prevalence of kidney cancer (KC) among the adult population of Ukraine and the Western region, as an example to identify certain territorial features and where about 22.4% of patients are concentrated. The main indicators of the results of providing specialized care to such patients were also studied. The main period was 2014–2018, the received data were compared with the previous five years. It was proved that both the incidence and the prevalence of pathology continue to grow in Ukraine and the Western region as a whole, with a similar rate against the background of slightly lower rates in the latter. The incidence rate is generally higher among males and significantly, as well as among females, did not differ in size. The prevalence rate is ahead of the incidence rate, which positively indicates the results of specialized care. Thus, the proportion of patients with newly diagnosed in stages I–II is gradually increasing, but it still remains quite high in stage IV – in every fourth in the country and the third in the region. This is partly due to the low percentage detected during professional examinations (up to 20%), the fluctuations of which have a negative trend. The consequence of the situation is the fact of practical stability of the dead up to a year from the time of diagnosis: in Ukraine in the range of 17–21.7%, in the region 18.3–23.7%. According to the positive trend, there is an increase in patients registered for і5 years; in 2018 to 61.7% and 61.4± 0.9% in Ukraine and the region, respectively. Up to 70% of patients with a first diagnosis receive special treatment. In its structure, the leading one is surgical (63.6±0.9% and 59.7±2.1 in the country and region); the percentage of complex or combined, which ranks second, accounts for 7.9% and 9.7%, respectively, it decreases across the country and increases in the region. Against the background of the general decrease in nephrectomies in Ukraine, their growth was observed in the case of KC everywhere. Every third and fourth operation, respectively, was performed in oblast-oncologic dispensaries. Over the years, postoperative mortality has decreased (by 21% to 1.23 in the whole country), in the region, in the absence of most oblasts, Lviv (by 2.4%) stood out in terms of size. There has been proved the need to focus on the issues of early diagnosis of the disease, which is in the plane of searching new opportunities with the involvement of biomarkers, and organizational measures of various directions.

Complex network analysis of combination medication of patients with kidney malignant tumor based in real world

Kidney malignant tumor is a type of primary renal cell carcinoma, and mainly refers to renal cancer. The incidence of kidney cancer and the number of hospital cases in China have been increasing. Based on the clinical medicine information of patients in the hospital information system(HIS) database of 37 hospitals in China, the combined medication of patients with kidney malignant tumor were analyzed by Tabu search algorithm, so as to analyze the combined medication of patients with kidney malignant tumor in real world. A total of 7 095 patients with kidney malignant tumor were included, the ratio of males to females was 2.11∶1, and the ratio of male patients increased gradually with age. About 3 933 patients(55.43%) showed a superior effect among those patients. The common therapies of patients with kidney malignant tumor were anti-tumor therapies and symptomatic therapies, including anti-infection, regulation of electrolyte balance, sedation and analgesia, analgesic, regulation of gastrointestinal function. The whole population of patients with kidney malignant tumor were mostly treated with anti-tumor drugs combined with more symptomatic therapies, while the anti-tumor therapies of the superiority population of patients were less combined with other drugs, with less combined medication. The result may be related to the stage of tumor or individual response to the therapeutic regimen. No matter for the whole population or for the superiority population of patients with kidney malignant tumor, the therapies was mainly Western medicines. Based on the pathogenesis of deficiency in origin and excess in superficiality with kidney malignant tumor, Chinese subgroups with formula for clearing heat and removing toxicity, formula for vigorate Qi and replenish the blood, formula for regulate Qi and invigorate the blood, laxative and hemostatic were more commonly used. In the future, further studies shall be conducted for combined therapies for patients of different stages, so as to play the advantages of multi-target, overall regulation, toxicity reduction and efficacy enhancement of traditional Chinese medicine, improve the life quality of patients with kidney malignant tumor, prolong their life time, and improve the survival rate of patients.

Determining generalizability of the Canadian Kidney Cancer information system (CKCis) to the entire Canadian kidney cancer population.

The Canadian Kidney Cancer information system (CKCis) has prospectively collected data on patients with renal tumors since January 1, 2011 from 16 sites within 14 academic centers in six provinces. Canadian kidney cancer experts have used CKCis data to address several research questions. The goal of this study was to determine if the CKCis cohort is representative of the entire Canadian kidney cancer population, specifically regarding demographic and geographic distributions. The CKCis prospective cohort was analyzed up to December 31, 2018. Baseline demographics and tumor characteristics were analyzed, including location of patients' residence at the time of CKCis entry. Geographic data is presented by province, rural vs. urban via postal code information (2nd digit=0) and by Canadian urban boundary files. To determine the proportion of renal cell carcinoma (RCC) patients that CKCis captures, CKCis accruals were compared to projected Canadian Cancer Society RCC incidence in 2016-2017 and the incidence from the 2016 Canadian Cancer Registry. To determine if the CKCis baseline data is representative, it was compared to registry data and other published data when registry data was not available. This CKCis cohort includes 10 298 eligible patients: 66.6% male, median age 62.6 years; 14.6% had metastatic disease at the time of diagnosis and 70.4% had clear-cell carcinomas. The CKCis cohort captures about 1250 patients per year, which represents approximately 20% of the total kidney cancer incidence. The proportion of patients captured per province did vary from 13-43%. Rural patients make up 17% of patients, with some baseline differences between rural and urban patients. There appears to be no major differences between CKCis patient demographics and disease characteristics compared to national data sources. Canadian heat maps detailing patient location are presented. CKCis contains prospective data on >10 000 Canadian kidney cancer patients, making it a valuable resource for kidney cancer research. The baseline demographic and geographic data do appear to include a broad cross-section of patients and seem to be highly representative of the Canadian kidney cancer population. Moving forward, future projects will include determining if CKCis cancer outcomes are also representative of the entire Canadian kidney cancer population and studying variations across provinces and within rural vs. urban areas.

Serum uric acid levels and risk of kidney cancer incidence and mortality: A prospective cohort study.

ObjectiveEpidemiological evidence investigating serum uric acid and kidney cancer risk remains unclear. We conducted this study to examine the relationship between serum uric acid and the incidence and mortality of kidney cancer.MethodsThis is a prospective analysis of 444 462 participants without any cancer from the UK Biobank. Serum uric acid was measured at baseline and the incidence and mortality of kidney cancer was determined through contact with the cancer and death registry. Cox regression models were fitted to estimate the hazard ratio (HR) and 95% confidence interval (95%CI), adjusting for demography, lifestyle style, comorbidities, and medication use.ResultsWe documented 638 incidence cases and 188 mortality cases of kidney cancer over a median of 6.5 years follow‐up. People with the highest quartile had a 45% increased risk of kidney cancer compared to those with the lowest uric acid quartile (HR 1.45, 95%CI 1.08 to 1.93). Subgroup analyses showed that serum uric acid was associated with cancer risk among females but not among males (Q1 vs Q4: females HR1.47, 95%CI 1.01 to 2.16; males HR 1.19, 95%CI 0.91 to 1.56). Although we found serum uric acid was associated with an increased risk of kidney cancer mortality in age‐stratified model (HR 2.49, 95% CI 1.61 to 3.84), this association disappeared after further adjustment for other confounders.ConclusionsHigh uric acid is associated with a high incidence of kidney cancer, especially in women. More research is needed to confirm our findings.

Abstract D074: Variations in genomic testing across cancer sites and by demographic characteristics

Abstract Study Objective: Genomic testing is essential to identify the best treatment modalities for certain cancers; yet, its uptake has been relatively low, especially among disadvantaged subgroups of the population. The aim of this study is to identify demographic and clinical factors associated with receipt of genomic testing in Ohioans diagnosed with either incident female breast, kidney, bladder, prostate, colorectal, or lung cancer. Methods: We used data from the 2009 linked Ohio Cancer Incidence Surveillance System and Medicare files, and identified genomic testing using the appropriate procedure codes in claims data. Our study population included 10,945 patients. Independent variables examined were age at diagnosis (&amp;lt; 65, 65-74, 75+), sex, race (White or All Other), dual enrollment in the Medicare and Medicaid program (or ‘dual’) as a marker for low income and heightened vulnerability, and advanced stage at diagnosis (Regional/Distant versus Local stage). We conducted multivariable logistic regression analysis to identify correlates of genomic testing by cancer site. Results: For all cancer sites combined, 11.1% were younger than 65, and 40.6% were older than 75 years of age. Eighty eight percent were White, 47.0% were women, 13.9% were duals, and one third were diagnosed with advanced-stage cancer. Overall, only 19.5% underwent genomic testing, ranging from a low of 6.7% in prostate cancer patients, to a high of 39.3% in breast cancer patients. In addition, we observed considerable variation in genomic testing by age, race, sex, dual status, and cancer stage across cancer sites. Adjusting for the independent variables listed above, being 75 years of age or older was significantly and positively associated with increased likelihood of undergoing genomic testing in breast (adjusted odds ratio: 1.17, 95% confidence interval: 1.04, 1.32), kidney and bladder combined (1.29 (1.09, 1.53)), and prostate cancer patients (1.45 (1.12, 1.89)). Advanced-stage disease was associated with increased likelihood of genomic testing in breast and colorectal cancer patients (1.40 (1.17, 1.67) and 3.07 (2.30, 4.11), respectively), but with decreased likelihood in kidney and bladder cancer patients (0.66 (0.48, 0.91)). Finally, we note that White patients with lung cancer were significantly more likely than others to undergo genomic testing (2.49 (1.29, 4.78)). Conclusion: Our data from 2009 provide baseline statistics on genomic testing uptake in Ohio. Data for subsequent years will help us to assess trends in providing personalized medicine. Citation Format: Siran Koroukian, Weichuan Dong, Johnie Rose, Fredrick Schumacher, Sarah Markt. Variations in genomic testing across cancer sites and by demographic characteristics [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D074.

Variability in surgical management of kidney cancer between urban and rural hospitals in Queensland, Australia: a population-based analysis.

BackgroundInternational guidelines recommend partial over radical nephrectomy for management of kidney tumours, due to perceived advantages of kidney function preservation. In Queensland, oncological nephrectomy is performed in both metropolitan and rural hospitals. Previous studies have shown that patients from rural areas with kidney tumours are less likely to undergo partial nephrectomy compared with those in major cities. The aim of this study was to investigate patterns of partial nephrectomy according to geographical area, and to identify patient- and health-service-level characteristics associated with partial nephrectomy.MethodsAll 3,799 incident kidney cancer cases in Queensland (Jan 2009 to Dec 2014) were ascertained. Patients aged <18 yrs (n=47), who did not receive surgery (n=988), or had end-stage kidney disease (ESKD) before surgery (n=17) were excluded. The final sample included 2,747 patients. Data were analysed using multivariable logistic regression in order to identify associations with partial nephrectomy.ResultsOf 2,747 patients, 637 (25%) underwent partial nephrectomy. The likelihood of undergoing partial nephrectomy increased with more recent year of surgery (P<0.001) and higher socioeconomic status (P<0.001). The likelihood of undergoing partial nephrectomy decreased for patients managed in lower-volume centres (P=0.004), with increasing age (P<0.001), and hospital location outside of a major city (P<0.001). Overall, the number of nephrectomies, and proportion/number of partial nephrectomies, performed in rural hospitals has increased over the study period.ConclusionsOur results suggest that, although patients who are managed in major cities are more likely to undergo partial nephrectomy, likelihood of undergoing partial nephrectomy in rural centres is increasing, consistent with international best practice.

Contemporary Age-adjusted Incidence and Mortality Rates of Renal Cell Carcinoma: Analysis According to Gender, Race, Stage, Grade, and Histology

BackgroundRecent data showed that North America has the highest incidence of renal cell carcinoma (RCC) worldwide. ObjectiveTo assess contemporary gender-, race-, and stage-specific incidence; survival rates; and trends of RCC patients in the USA. Design, setting, and participantsWithin the Surveillance, Epidemiology, and End Results database (2001–2016), all patients aged ≥18 yr with histologically confirmed renal parenchymal tumors were included. Outcome measurements and statistical analysisAge-adjusted incidence rates and 5-yr cancer-specific survival (CSS) rates were estimated. Temporal trends were calculated through Joinpoint regression analyses to describe the average annual percent change (AAPC). Results and limitationsThe age-adjusted incidence rate of RCC was 11.3/100 000 person years (AAPC+2.0%, p<0.001). Five-year CSS rates increased from 78.4% to 84.5% (AAPC +0.8%, p<0.001). Male incidence was double that of females (15.5 and 7.7, respectively). CSS marginally favored females (84.5% vs 82.0%), but improved equally in both genders (both AAPC +0.8%). The highest incidence (14.1/100 000 person years, AAPC +2.8%) and lowest survival (80.1%) were recorded in non-Hispanic American Indian/Alaska Native populations. T1aN0M0 had the highest incidence rates (4.6/100 000 person years), the highest increase over time (AAPC +3.6%), and the highest CSS (97.6%) of all stages. Limitations include retrospective nature and lack of information on risk factors. ConclusionsThe incidence of RCC increased significantly from 2001 to 2016, and 5-yr CSS after RCC improved. This was mainly due to T1aN0M0 tumors that showed the highest increase in the incidence and highest CSS. Unfavorable outcomes in specific ethnic groups warrant further research. Patient summaryWe examined contemporary incidence and cancer-specific survival rates of kidney cancer. Males had double the incidence rates of females, but lower survival. Natives showed the highest incidence rates and the lowest survival rates. Small renal masses showed the highest incidence and survival rates.

Trends and projections of kidney cancer incidence at the global and national levels, 1990\u20132030: a Bayesian age-period-cohort modeling study

BackgroundIdentifying the temporal trends of kidney cancer (KC) incidence in both the past and the future at the global and national levels is critical for KC prevention.MethodsWe retrieved annual KC case data between 1990 and 2017 from the Global Burden of Disease (GBD) online database. The average annual percentage change (AAPC) was used to quantify the temporal trends of KC age-standardized incidence rates (ASRs) from 1990 to 2017. Bayesian age-period-cohort models were used to predict KC incidence through 2030.ResultsWorldwide, the number of newly diagnosed KC cases increased from 207.3 thousand in 1990 to 393.0 thousand in 2017. The KC ASR increased from 4.72 per 100,000 to 4.94 per 100,000 during the same period. Between 2018 and 2030, the number of KC cases is projected to increase further to 475.4 thousand (95% highest density interval [HDI] 423.9, 526.9). The KC ASR is predicted to decrease slightly to 4.46 per 100,000 (95% HDI 4.06, 4.86). A total of 90, 2, and 80 countries or territories are projected to experience increases, remain stable, and experience decreases in KC ASR between 2018 and 2030, respectively. In most developed countries, the KC incidence is forecasted to decrease irrespective of past trends. In most developing countries, the KC incidence is predicted to increase persistently through 2030.ConclusionsKC incidence is predicted to decrease in the next decade, and this predicted decrease is mainly driven by the decreases in developed countries. More attention should be placed on developing countries.

Incidence of kidney cancer after liver transplantation: a meta-analysis.

The purpose of this systematic review and meta-analysis was to investigate the relationship between liver transplantation and kidney cancer. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed. PubMed, the Web of Science, and the Cochrane databases were searched for peer-reviewed cohort studies in which standardized incidence of kidney cancer post-transplant was compared to the general population by means of standardized incidence ratio (SIR) with 95% confidence interval (CI). No limits were placed on language or year of publication. A fixed-effects model was used for pooling the data. Of the 937 citations identified from the electronic databases, we included nine cohort studies with 53913 liver transplant patients, a male percentage of 56.8% and a minimum follow-up of 12.4 months and more. The meta-analysis revealed that liver transplant recipients faced a significantly higher risk of developing kidney cancer than the general population with the pooled SIR of 2.02 (95% CI, 1.64-2.50; P < 0.001). No significant between-study heterogeneity was observed (I = 0, Phet = 0.553). On sensitivity analysis after removing the study by Engles et al. with the largest sample size (37 888 liver transplant recipients), the SIR remained stable (SIR 2.75; 95% CI, 1.85-4.10; P < 0.001). Overall, our synthesis of the literature indicates that an increased risk of kidney cancer exists after liver transplantation. Future studies should evaluate the potential risk factors associated with kidney cancer.

MON-330 Cancer Incidence in 1,296 Patients with Acromegaly Is Not Increased: A Nationwide Population-Based Study

Background: Single- and multi-center studies have shown an increased incidence of malignancies in patients with acromegaly. These findings may be affected by selection bias. Our aim was therefore to investigate the incidence of malignancies in a nationwide unselected cohort of patients with acromegaly. Methods: Adult patients diagnosed with acromegaly due to a pituitary tumor between 1987 and 2017 were identified in the Swedish National Patient Registry. All malignancies following the diagnosis of acromegaly were identified in the Swedish Cancer Registry that has a coverage of over 96%. Standardized incidence ratios (SIRs) for malignancies, with 95% confidence intervals (CI), were calculated by using the Swedish general population as a reference. Incidence of malignancies was also analyzed in sub-groups of patients treated with radiotherapy and in those having diabetes mellitus and hypopituitarism. Results: A total of 1,296 patients with acromegaly were included (621 men, 675 women). The mean age (±SD) at diagnosis was 51.6±14.7 years. The mean follow-up was 12.7±8.3 years, with a total of 16,395 person years at risk. Pituitary surgery was performed in 842 (65%) patients and radiation therapy in 152 (12%) patients. The diagnosis of hypopituitarism and diabetes mellitus was recorded in 29% and 16% of patients, respectively. Overall, 186 malignancies were identified in patients with acromegaly as compared to 179 expected malignancies in the general population (SIR 1.04; 95% CI 0.90-1.20). Incidence of malignancies was similar in men and women [SIR 1.08 (95% CI 0.88-1.32) vs 1.00 (95% CI 0.80-1.23)]. Incidence of colorectal cancer (SIR 1.12; 95% CI 0.75-1.62) or malignancies of the respiratory system (SIR 1.22; 95% CI 0.76-1.84) was not increased. Incidence of kidney and ureter cancer (n=17) was, however, increased (SIR 3.81; 95% CI 2.22-6.11). In the entire study cohort, only three cases of thyroid cancer were recorded. SIR for malignancies in patients treated with radiotherapy (1.12; 95% CI 0.56-2.01) and in patients with hypopituitarism (SIR0.91; 95% CI 0.68-1.18) or diabetes (SIR 1.08; 95% CI 0.78-1.45) did not differ from the general population. Conclusions: This large nationwide population-based study showed that the overall incidence of malignancies in patients with acromegaly was not different from the general population. In particular, incidence of colorectal and thyroid cancer was not increased. Incidence of malignancies of the urinary tract was, however, increased.

Dietary Intakes of Trace Elements and the Risk of Kidney Cancer: The Singapore Chinese Health Study

Background: Epidemiological studies have demonstrated separately that patients with kidney stone may have higher dietary intake of zinc and higher risk of developing kidney cancer. We prospectively assessed the associations of dietary zinc and other trace elements with kidney cancer risk for the first time.Methods: We used data from the prospective Singapore Chinese Health Study that recruited 63,257 adult Chinese residing in Singapore between 1993 and 1998. A validated food frequency questionnaire and the Singapore Food Composition Database was used to compute the values of intake for zinc, copper and manganese. We identified incident cancer cases via linkage with nationwide cancer registry, and used Cox proportional hazard models to compute hazard ratio (HR) and 95% confidence interval (CI) for the association with kidney cancer risk.Results: There were 229 incident kidney cancer cases after median follow-up of 20.1 years. Dietary zinc intake was positively associated with higher kidney cancer risk; the HR comparing the extreme quartiles of zinc intake was 1.74 (95% CI: 1.02-2.97; P-trend = 0.033). Conversely, intakes of copper and manganese were not associated with kidney cancer risk.Conclusions: The positive association between dietary zinc and risk of kidney cancer suggests that zinc may be implicated in renal carcinogenesis.

Temporal trends of kidney cancer incidence and mortality from 1990 to 2016 and projections to 2030.

BackgroundThis study aims to present the trends of incidence and mortality of kidney cancer from 1990 to 2016 by age, gender, geographical region, regional, and sociodemographic index (SDI), and then forecast the future trends to 2030.MethodsData of this study were gathered from the Global Burden of Disease Study (GBD), including 195 countries and territories, accounting for 21 regions. Over-time trends from 1990 to 2016 were analyzed by gender, geographical region, age range and SDI. Based on the big data, we forecasted the future trends to 2030 by ARIMA model. All the data were analyzed by R software (x64 version 3.5.1), SAS (version 9.3) and SPSS (version 22.0).ResultsGlobally, in 2016, there were 342,100 [95% uncertainty interval (UI), 330,759–349,934] incident cases of kidney cancer and the number of deaths were 131,800 (127,335–136,185). The age-standardized incidence rate (ASIR) and death rate (ASDR) were 4.97 (4.81–5.09) per 100,000 and 2.00 (1.93–2.06) per 100,000, respectively. Globally, the estimated risk of kidney cancer for male within the age of 30 and 70 is around 0.79% compared to 0.41% for female. In other words, the probability of developing kidney cancer was generally higher in male than in female. By 2030, incidence of kidney cancer in both sexes are projected to increase substantially in high SDI, followed by middle SDI, low-middle SDI, and low SDI countries. High SDI and low SDI countries will also have increased mortality rates of kidney cancers. Globally, the trends in deaths due to kidney cancer will remain stable.ConclusionsThe incidence and death rate of kidney cancer are highly variable among SDI countries and regions but have increased uniformly from 1990 to 2016. By 2030, the future incidence of kidney cancer will grow continuously especially in high SDI countries, middle SDI, low-middle SDI, and low SDI countries.

MP50-01 ASSOCIATION BETWEEN KIDNEY FUNCTION, PROTEINURIA AND THE RISK OF KIDNEY CANCER

INTRODUCTION AND OBJECTIVE: While decreased renal function is a well-known risk factor of kidney cancer (KC), association of proteinuria with KC is unclear. In this large cohort study, we evaluated the risk of KC according to glomerular filtration rate (GFR) and dipstick proteinuria, as well as the joint effects between the two. METHODS: A total of 9,809,366 participants who participated in the nationwide health screening program in 2009 and did not have history of any cancer were included. The impact of GFR, dipstick proteinuria, and interactive associations of the two factors on the development of KC were analyzed. RESULTS: During the median follow-up of 7.3 years, 10,634 participants developed KC (overall incidence rate: 14.9 per 100,000 person-years). Subjects with low GFR (<60 mL/min/1.73 m2) had a higher incidence of KC (adjusted hazard ratio [aHR] 1.26, 95% CI 1.18-1.34) than those with a high GFR (≥ 60). When GFR of 60-90 was considered the reference group, KC risk was higher in low GFR groups: GFR <30 (aHR 1.21) and GFR 30-60 group (aHR 1.27), while there was no decreased risk in higher GFR groups (GFR >90 or ≥ 120). A clear dose-response relationship was also found with the degree of dipstick proteinuria; compared to the no proteinuria group, even the trace group had an elevated risk of KC (aHR 1.20) and the risk increased more than double in the 4+ proteinuria group (aHR 2.15). Analyses of joint effects of GFR and dipstick proteinuria showed that in the no proteinuria group, the increased incidence of KC was less evident with decreasing GFR, whereas in the proteinuria group, there was marked increase in KC incidence along with decreasing GFR (Figure 1). The association between smoking and KC was more evident in low GFR groups (GFR <30 and GFR 30-60) (P-interaction <0.001), while there were no interactions between smoking and proteinuria. Clinically significant association was not found between BMI and GFR/proteinuria. CONCLUSIONS: Low GFR and proteinuria were associated with future KC development, possibly in synergistic manner. Smoking had a more profound effect when GFR was lower. Further research is warranted to develop strategies to reduce cancer risk in the CKD population.Source of Funding: This work was supported by a creative research program grant from Samsung Medical Center.

Components of one-carbon metabolism and renal cell carcinoma: a systematic review and meta-analysis

PurposeLittle is known about the aetiology of renal cell carcinoma (RCC). Components of one-carbon (1C) metabolism, which are required for nucleotide synthesis and methylation reactions, may be related to risk of RCC but existing evidence is inconclusive. We conducted a systematic review and independent exposure-specific meta-analyses of dietary intake and circulating biomarkers of 1C metabolites and RCC risk.MethodsMedline and Embase databases were searched for observational studies investigating RCC or kidney cancer incidence or mortality in relation to components of 1C metabolism and 12 eligible articles were included in the meta-analyses. We used Bayesian meta-analyses to estimate summary relative risks (RRs) and 95% credible intervals (CrIs) comparing the highest versus lowest categories as well as the between-study heterogeneity.ResultsWe did not find convincing evidence of an association between any exposure (riboflavin, vitamin B6, folate, vitamin B12, methionine, homocysteine, choline, or betaine) and RCC risk. However, vitamin B6 biomarker status did have a protective (RR = 0.62) but imprecise (95% CrI 0.39–1.14) effect estimate and folate intake had a notable association as well (RR = 0.85, 95% CrI 0.71–1.01).ConclusionThere was a lack of precision due largely to the low number of studies. Further investigation is warranted, especially for folate and vitamin B6, which had consistent suggestive evidence of a protective effect for both dietary intake and biomarker status. A unique strength of this review is the use of Bayesian meta-analyses which allowed for robust estimation of between-study heterogeneity.

Smoking-adjusted risk of kidney cancer by occupation: a population-based cohort study of Nordic men

Background: Evidence suggests that among some occupational groups, there is an elevated risk of kidney cancer. This might, however, derive from a difference in smoking habits across occupational groups. The objective of this study was to determine smoking-adjusted occupational variation in the incidence of kidney cancer in Nordic males.Material and Methods: The source population for this study consisted of 7.4 million men from Denmark, Iceland, Finland, Norway, and Sweden. Data on occupation were obtained from national censuses conducted in the years 1960–1990. Data on cancer cases came from national cancer registries. A proxy for the occupation-specific smoking prevalence among all Nordic men was calculated based on the occupation-specific smoking prevalence and lung cancer incidence data for Finnish men. Smoking-adjusted standardized incidence ratio (SIRadj) with 95% confidence intervals (95%CI) were calculated for each occupational group.Results: The highest SIRadj estimates were observed in dentists (1.32, 95%CI 1.06–1.62), journalists (1.20, 95%CI 1.00–1.42), physicians (1.19, 95%CI 1.03–1.36), public safety workers (1.18, 95%CI 1.10–1.26), administrators (1.17, 95%CI 1.13–1.22), military personnel (1.16, 95%CI 1.05–1.28), and religious workers (1.17, 95%CI 1.09–1.26). The lowest SIRadj was observed among forestry workers (0.82, 95%CI 0.76–0.88).Conclusions: Tobacco smoking plays an important role in the occupational variation in the risk of kidney cancer. The smoking-adjusted incidence of kidney cancer was increased in dentists, physicians, journalists, administrators, and public safety workers.

Body mass index and other risk factors for kidney cancer in men: a cohort study in Lithuania.

Previous studies have observed notable unexplained geographic differences in incidence of kidney cancer in Europe. Lithuania is among the countries with the highest incidence and mortality. Our objective was to investigate the effect of different lifestyle, anthropometric and biological factors on the risk of kidney cancer in Lithuanian men. This population-based cohort study included 6,849 men initially free from cancer. During the follow-up (1978-2008), 79 incident cases of kidney cancer were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). Risk of kidney cancer was significantly associated with increasing body mass index (BMI), the adjusted HR for ≥ 35 vs. < 25 kg/m2 was 3.00, 95% CI 1.10-8.19 and the HR per 1 unit increment of BMI was 1.07, 95% CI 1.01-1.14. In overweight men (BMI ≥ 25 kg/m2), the HRs for kidney cancer per 10 mmHg increment of systolic or diastolic blood pressure were 1.10, 95% CI 0.96-1.25 and 1.26, 95% CI 1.01-1.56, respectively. We found no significant association between smoking, alcohol consumption or total serum cholesterol level and kidney cancer risk. This study supports a link between increased BMI and the development of kidney cancer among men in Lithuania. Hypertension appears to be associated with risk of kidney cancer in overweight men, although the assessment was limited by the lack of statistical power.

Trends in cancer incidence in Uruguay: 2002 -2015.

Background: Uruguay is the south American country which has the highest cancer incidence and mortality rates. The National Cancer Registry collects data on cancer cases nationwide since 1989 and has reached high quality standards in the last decades. This is the first report on incidence trends. Methods: Data from the National Cancer Registry of all new cases of invasive cancer from twelve sites diagnosed in 2002-2015 was analyzed. Age-standardized rates were calculated. Trends of incidence rates were analyzed using joinpoint regression models. Results: For both, men and women, incidence rates trends for all cancer sites, colo-rectal and bladder cancer remained stable. Esophageal and gastric cancers descended while thyroid and kidney cancer incidence increased. In men lung cancer decreased; testicular cancer increased, and prostate cancer increased at the beginning of the period and decreased in the final years. In women, lung cancer increased, breast cancer remained stable and cervical cancer presented a significant decline from 2005 to 2010 and reached a plateau since then.Conclusion: Cancer incidence dynamics are complex and affected not only by Public Health policies such as tobacco control, vaccination and screening programs, but also by environmental and life style changes and the attitude of the medical community towards the application of diagnostic and therapeutic tools. The aim of this paper is to analyze cancer incidence time trends in the country and provide possible explanations to them.