Risk Factors for Renal Cell Carcinoma in the Vitamin and Lifestyle (VITAL) Study.

Publication Type:

Journal Article


The Journal of urology, Volume 190, Issue 5, p.1657-61 (2013)


2013, Center-Authored Paper, Epidemiology Core Facility, June 2013, Nutrition Assessment Core Facility, Public Health Sciences Division


PURPOSE: The incidence of renal cell carcinoma (RCC) is increasing worldwide. Cited risk factors include obesity, smoking and hypertension, but few others have been confirmed by prospective studies. We used a prospective cohort to validate established RCC risk factors and to evaluate more controversial risk factors for incident RCC. MATERIALS/METHODS: 77,260 residents of Washington aged 50-76 years completed a questionnaire between 2000-2002 on demographic, lifestyle and health data. Incident RCC cases were determined through linkage to the regional cancer registry through Dec 31, 2009. Multivariate methods using covariates and cut offs selecteda priori analyzed the association between RCC and previously studied factors related to lifestyle (body mass index [BMI], smoking, alcohol/fruit/vegetable consumption) and health (hypertension, diabetes, kidney disease, viral hepatitis). RESULTS: There were 249 incident cases of RCC. Independent RCC risk factors in the fully adjusted model with HR and 95% CIs were: BMI (HR 1.71, CI 1.06, 2.79, for >=35 kg/m(2) vs. <25 kg/m(2)), smoking (HR 1.67, CI 1.16, 2.42, for >=37.5 pack-years vs. none), hypertension (HR 1.70, CI 1.30, 2.22), kidney disease (HR 2.58, CI 1.21, 5.50), viral hepatitis (HR 1.80, CI 1.03, 3.14). Diabetes was associated with RCC (HR 1.83, CI 1.26, 2.65) in a base model adjusting for age and gender, but not in the multivariate model. We found no association between alcohol, fruit, or vegetable intake and RCC. CONCLUSIONS: We identified significant association between RCC and obesity, smoking, hypertension, renal disease and viral hepatitis. Identification of risk factors offers an opportunity for targeted education and intervention.