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British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Sep;85(7):984–990. doi: 10.1054/bjoc.2001.2040

Obesity and renal cell cancer – a quantitative review

A Bergström 1, C-C Hsieh 3,5, P Lindblad 1,2, C-M Lu 3,4, N R Cook 6, A Wolk 1
PMCID: PMC2375100  PMID: 11592770

Abstract

Obesity has been associated with an increased risk of renal cell cancer among women, while the evidence for men is considered weaker. We conducted a quantitative summary analysis to evaluate the existing evidence that obesity increases the risk of renal cell cancer both among men and women. We identified all studies examining body weight in relation to kidney cancer, available in MEDLINE from 1966 to 1998. The quantitative summary analysis was limited to studies assessing obesity as body mass index (BMI, kg m−2), or equivalent. The risk estimates and the confidence intervals were extracted from the individual studies, and a mixed effect weighted regression model was used. We identified 22 unique studies on each sex, and the quantitative analysis included 14 studies on men and women, respectively. The summary relative risk estimate was 1.07 (95% CI 1.05–1.09) per unit of increase in BMI (corresponding to 3 kg body weight increase for a subject of average height). We found no evidence of effect modification by sex. Our quantitative summary shows that increased BMI is equally strongly associated with an increased risk of renal cell cancer among men and women. © 2001 Cancer Research Campaignhttp://www.bjcancer.com

Keywords: kidney neoplasms, obesity, body weight/body mass index, risk factors, meta-analysis

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Selected References

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  1. Asal N. R., Geyer J. R., Risser D. R., Lee E. T., Kadamani S., Cherng N. Risk factors in renal cell carcinoma. II. Medical history, occupation, multivariate analysis, and conclusions. Cancer Detect Prev. 1988;13(3-4):263–279. [PubMed] [Google Scholar]
  2. Benhamou S., Lenfant M. H., Ory-Paoletti C., Flamant R. Risk factors for renal-cell carcinoma in a French case-control study. Int J Cancer. 1993 Aug 19;55(1):32–36. doi: 10.1002/ijc.2910550107. [DOI] [PubMed] [Google Scholar]
  3. Benichou J., Chow W. H., McLaughlin J. K., Mandel J. S., Fraumeni J. F., Jr Population attributable risk of renal cell cancer in Minnesota. Am J Epidemiol. 1998 Sep 1;148(5):424–430. doi: 10.1093/oxfordjournals.aje.a009667. [DOI] [PubMed] [Google Scholar]
  4. Berkey C. S., Hoaglin D. C., Mosteller F., Colditz G. A. A random-effects regression model for meta-analysis. Stat Med. 1995 Feb 28;14(4):395–411. doi: 10.1002/sim.4780140406. [DOI] [PubMed] [Google Scholar]
  5. Black R. J., Bray F., Ferlay J., Parkin D. M. Cancer incidence and mortality in the European Union: cancer registry data and estimates of national incidence for 1990. Eur J Cancer. 1997 Jun;33(7):1075–1107. doi: 10.1016/s0959-8049(96)00492-3. [DOI] [PubMed] [Google Scholar]
  6. Boeing H., Schlehofer B., Wahrendorf J. Diet, obesity and risk for renal cell carcinoma: results from a case control-study in Germany. Z Ernahrungswiss. 1997 Mar;36(1):3–11. doi: 10.1007/BF01618893. [DOI] [PubMed] [Google Scholar]
  7. Chow W. H., Devesa S. S., Warren J. L., Fraumeni J. F., Jr Rising incidence of renal cell cancer in the United States. JAMA. 1999 May 5;281(17):1628–1631. doi: 10.1001/jama.281.17.1628. [DOI] [PubMed] [Google Scholar]
  8. Chow W. H., McLaughlin J. K., Mandel J. S., Wacholder S., Niwa S., Fraumeni J. F., Jr Obesity and risk of renal cell cancer. Cancer Epidemiol Biomarkers Prev. 1996 Jan;5(1):17–21. [PubMed] [Google Scholar]
  9. Cole P., MacMahon B. Attributable risk percent in case-control studies. Br J Prev Soc Med. 1971 Nov;25(4):242–244. doi: 10.1136/jech.25.4.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Devesa S. S., Silverman D. T., McLaughlin J. K., Brown C. C., Connelly R. R., Fraumeni J. F., Jr Comparison of the descriptive epidemiology of urinary tract cancers. Cancer Causes Control. 1990 Sep;1(2):133–141. doi: 10.1007/BF00053164. [DOI] [PubMed] [Google Scholar]
  11. Finkle W. D., McLaughlin J. K., Rasgon S. A., Yeoh H. H., Low J. E. Increased risk of renal cell cancer among women using diuretics in the United States. Cancer Causes Control. 1993 Nov;4(6):555–558. doi: 10.1007/BF00052431. [DOI] [PubMed] [Google Scholar]
  12. Flegal K. M., Carroll M. D., Kuczmarski R. J., Johnson C. L. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998 Jan;22(1):39–47. doi: 10.1038/sj.ijo.0800541. [DOI] [PubMed] [Google Scholar]
  13. Frystyk J., Vestbo E., Skjaerbaek C., Mogensen C. E., Orskov H. Free insulin-like growth factors in human obesity. Metabolism. 1995 Oct;44(10 Suppl 4):37–44. doi: 10.1016/0026-0495(95)90219-8. [DOI] [PubMed] [Google Scholar]
  14. Gamble J. F., Pearlman E. D., Nicolich M. J. A nested case-control study of kidney cancer among refinery/petrochemical workers. Environ Health Perspect. 1996 Jun;104(6):642–650. doi: 10.1289/ehp.96104642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Goodman M. T., Morgenstern H., Wynder E. L. A case-control study of factors affecting the development of renal cell cancer. Am J Epidemiol. 1986 Dec;124(6):926–941. doi: 10.1093/oxfordjournals.aje.a114482. [DOI] [PubMed] [Google Scholar]
  16. Greenland S., Longnecker M. P. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol. 1992 Jun 1;135(11):1301–1309. doi: 10.1093/oxfordjournals.aje.a116237. [DOI] [PubMed] [Google Scholar]
  17. Hall J. E. Louis K. Dahl Memorial Lecture. Renal and cardiovascular mechanisms of hypertension in obesity. Hypertension. 1994 Mar;23(3):381–394. doi: 10.1161/01.hyp.23.3.381. [DOI] [PubMed] [Google Scholar]
  18. Heath C. W., Jr, Lally C. A., Calle E. E., McLaughlin J. K., Thun M. J. Hypertension, diuretics, and antihypertensive medications as possible risk factors for renal cell cancer. Am J Epidemiol. 1997 Apr 1;145(7):607–613. doi: 10.1093/oxfordjournals.aje.a009157. [DOI] [PubMed] [Google Scholar]
  19. Hiatt R. A., Tolan K., Quesenberry C. P., Jr Renal cell carcinoma and thiazide use: a historical, case-control study (California, USA). Cancer Causes Control. 1994 Jul;5(4):319–325. doi: 10.1007/BF01804982. [DOI] [PubMed] [Google Scholar]
  20. Kadamani S., Asal N. R., Nelson R. Y. Occupational hydrocarbon exposure and risk of renal cell carcinoma. Am J Ind Med. 1989;15(2):131–141. doi: 10.1002/ajim.4700150202. [DOI] [PubMed] [Google Scholar]
  21. Kellerer M., von Eye Corleta H., Mühlhöfer A., Capp E., Mosthaf L., Bock S., Petrides P. E., Häring H. U. Insulin- and insulin-like growth-factor-I receptor tyrosine-kinase activities in human renal carcinoma. Int J Cancer. 1995 Sep 4;62(5):501–507. doi: 10.1002/ijc.2910620502. [DOI] [PubMed] [Google Scholar]
  22. Kopelman P. G. Obesity as a medical problem. Nature. 2000 Apr 6;404(6778):635–643. doi: 10.1038/35007508. [DOI] [PubMed] [Google Scholar]
  23. Kreiger N., Marrett L. D., Dodds L., Hilditch S., Darlington G. A. Risk factors for renal cell carcinoma: results of a population-based case-control study. Cancer Causes Control. 1993 Mar;4(2):101–110. doi: 10.1007/BF00053150. [DOI] [PubMed] [Google Scholar]
  24. Kuskowska-Wolk A., Karlsson P., Stolt M., Rössner S. The predictive validity of body mass index based on self-reported weight and height. Int J Obes. 1989;13(4):441–453. [PubMed] [Google Scholar]
  25. Landis S. H., Murray T., Bolden S., Wingo P. A. Cancer statistics, 1999. CA Cancer J Clin. 1999 Jan-Feb;49(1):8-31, 1. doi: 10.3322/canjclin.49.1.8. [DOI] [PubMed] [Google Scholar]
  26. Lew E. A., Garfinkel L. Variations in mortality by weight among 750,000 men and women. J Chronic Dis. 1979;32(8):563–576. doi: 10.1016/0021-9681(79)90119-x. [DOI] [PubMed] [Google Scholar]
  27. Li J. J., Li S. A., Oberley T. D., Parsons J. A. Carcinogenic activities of various steroidal and nonsteroidal estrogens in the hamster kidney: relation to hormonal activity and cell proliferation. Cancer Res. 1995 Oct 1;55(19):4347–4351. [PubMed] [Google Scholar]
  28. Lindblad P., Chow W. H., Chan J., Bergström A., Wolk A., Gridley G., McLaughlin J. K., Nyrén O., Adami H. O. The role of diabetes mellitus in the aetiology of renal cell cancer. Diabetologia. 1999 Jan;42(1):107–112. doi: 10.1007/s001250051122. [DOI] [PubMed] [Google Scholar]
  29. Lindblad P., Wolk A., Bergström R., Persson I., Adami H. O. The role of obesity and weight fluctuations in the etiology of renal cell cancer: a population-based case-control study. Cancer Epidemiol Biomarkers Prev. 1994 Dec;3(8):631–639. [PubMed] [Google Scholar]
  30. Liu S., Semenciw R., Morrison H., Schanzer D., Mao Y. Kidney cancer in Canada: the rapidly increasing incidence of adenocarcinoma in adults and seniors. Can J Public Health. 1997 Mar-Apr;88(2):99–104. doi: 10.1007/BF03403870. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Maclure M., Willett W. A case-control study of diet and risk of renal adenocarcinoma. Epidemiology. 1990 Nov;1(6):430–440. doi: 10.1097/00001648-199011000-00004. [DOI] [PubMed] [Google Scholar]
  32. McCredie M., Stewart J. H. Risk factors for kidney cancer in New South Wales, Australia. II. Urologic disease, hypertension, obesity, and hormonal factors. Cancer Causes Control. 1992 Jul;3(4):323–331. doi: 10.1007/BF00146885. [DOI] [PubMed] [Google Scholar]
  33. McLaughlin J. K., Chow W. H., Mandel J. S., Mellemgaard A., McCredie M., Lindblad P., Schlehofer B., Pommer W., Niwa S., Adami H. O. International renal-cell cancer study. VIII. Role of diuretics, other anti-hypertensive medications and hypertension. Int J Cancer. 1995 Oct 9;63(2):216–221. doi: 10.1002/ijc.2910630212. [DOI] [PubMed] [Google Scholar]
  34. McLaughlin J. K., Gao Y. T., Gao R. N., Zheng W., Ji B. T., Blot W. J., Fraumeni J. F., Jr Risk factors for renal-cell cancer in Shanghai, China. Int J Cancer. 1992 Oct 21;52(4):562–565. doi: 10.1002/ijc.2910520411. [DOI] [PubMed] [Google Scholar]
  35. McLaughlin J. K., Lindblad P., Mellemgaard A., McCredie M., Mandel J. S., Schlehofer B., Pommer W., Adami H. O. International renal-cell cancer study. I. Tobacco use. Int J Cancer. 1995 Jan 17;60(2):194–198. doi: 10.1002/ijc.2910600211. [DOI] [PubMed] [Google Scholar]
  36. McLaughlin J. K., Lipworth L. Epidemiologic aspects of renal cell cancer. Semin Oncol. 2000 Apr;27(2):115–123. [PubMed] [Google Scholar]
  37. McLaughlin J. K., Mandel J. S., Blot W. J., Schuman L. M., Mehl E. S., Fraumeni J. F., Jr A population--based case--control study of renal cell carcinoma. J Natl Cancer Inst. 1984 Feb;72(2):275–284. [PubMed] [Google Scholar]
  38. Mellemgaard A., Engholm G., McLaughlin J. K., Olsen J. H. Risk factors for renal-cell carcinoma in Denmark. III. Role of weight, physical activity and reproductive factors. Int J Cancer. 1994 Jan 2;56(1):66–71. doi: 10.1002/ijc.2910560113. [DOI] [PubMed] [Google Scholar]
  39. Mellemgaard A., Lindblad P., Schlehofer B., Bergström R., Mandel J. S., McCredie M., McLaughlin J. K., Niwa S., Odaka N., Pommer W. International renal-cell cancer study. III. Role of weight, height, physical activity, and use of amphetamines. Int J Cancer. 1995 Jan 27;60(3):350–354. doi: 10.1002/ijc.2910600313. [DOI] [PubMed] [Google Scholar]
  40. Mellemgaard A., Møller H., Olsen J. H., Jensen O. M. Increased risk of renal cell carcinoma among obese women. J Natl Cancer Inst. 1991 Nov 6;83(21):1581–1582. doi: 10.1093/jnci/83.21.1581. [DOI] [PubMed] [Google Scholar]
  41. Muscat J. E., Hoffmann D., Wynder E. L. The epidemiology of renal cell carcinoma. A second look. Cancer. 1995 May 15;75(10):2552–2557. doi: 10.1002/1097-0142(19950515)75:10<2552::aid-cncr2820751023>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  42. Møller H., Mellemgaard A., Lindvig K., Olsen J. H. Obesity and cancer risk: a Danish record-linkage study. Eur J Cancer. 1994;30A(3):344–350. doi: 10.1016/0959-8049(94)90254-2. [DOI] [PubMed] [Google Scholar]
  43. Parkin D. M. The global burden of cancer. Semin Cancer Biol. 1998 Aug;8(4):219–235. doi: 10.1006/scbi.1998.0080. [DOI] [PubMed] [Google Scholar]
  44. Partanen T., Heikkilä P., Hernberg S., Kauppinen T., Moneta G., Ojajärvi A. Renal cell cancer and occupational exposure to chemical agents. Scand J Work Environ Health. 1991 Aug;17(4):231–239. doi: 10.5271/sjweh.1708. [DOI] [PubMed] [Google Scholar]
  45. Prineas R. J., Folsom A. R., Zhang Z. M., Sellers T. A., Potter J. Nutrition and other risk factors for renal cell carcinoma in postmenopausal women. Epidemiology. 1997 Jan;8(1):31–36. doi: 10.1097/00001648-199701000-00005. [DOI] [PubMed] [Google Scholar]
  46. Ribstein J., du Cailar G., Mimran A. Combined renal effects of overweight and hypertension. Hypertension. 1995 Oct;26(4):610–615. doi: 10.1161/01.hyp.26.4.610. [DOI] [PubMed] [Google Scholar]
  47. Rosenthal R., Kleid J. J., Cohen M. V. Abnormal mitral valve motion associated with ventricular septal defect following acute myocardial infarction. Am Heart J. 1979 Nov;98(5):638–641. doi: 10.1016/0002-8703(79)90291-6. [DOI] [PubMed] [Google Scholar]
  48. Schlehofer B., Pommer W., Mellemgaard A., Stewart J. H., McCredie M., Niwa S., Lindblad P., Mandel J. S., McLaughlin J. K., Wahrendorf J. International renal-cell-cancer study. VI. the role of medical and family history. Int J Cancer. 1996 Jun 11;66(6):723–726. doi: 10.1002/(SICI)1097-0215(19960611)66:6<723::AID-IJC2>3.0.CO;2-1. [DOI] [PubMed] [Google Scholar]
  49. Stadler W., Vogelzang N. J. Human renal cancer carcinogenesis: a review of recent advances. Ann Oncol. 1993 Jun;4(6):451–462. doi: 10.1093/oxfordjournals.annonc.a058550. [DOI] [PubMed] [Google Scholar]
  50. Takkouche B., Cadarso-Suárez C., Spiegelman D. Evaluation of old and new tests of heterogeneity in epidemiologic meta-analysis. Am J Epidemiol. 1999 Jul 15;150(2):206–215. doi: 10.1093/oxfordjournals.aje.a009981. [DOI] [PubMed] [Google Scholar]
  51. Talamini R., Barón A. E., Barra S., Bidoli E., La Vecchia C., Negri E., Serraino D., Franceschi S. A case-control study of risk factor for renal cell cancer in northern Italy. Cancer Causes Control. 1990 Sep;1(2):125–131. doi: 10.1007/BF00053163. [DOI] [PubMed] [Google Scholar]
  52. Whittemore A. S., Paffenbarger R. S., Jr, Anderson K., Lee J. E. Early precursors of site-specific cancers in college men and women. J Natl Cancer Inst. 1985 Jan;74(1):43–51. [PubMed] [Google Scholar]
  53. Whittemore A. S., Paffenbarger R. S., Jr, Anderson K., Lee J. E. Early precursors of urogenital cancers in former college men. J Urol. 1984 Dec;132(6):1256–1261. doi: 10.1016/s0022-5347(17)50118-4. [DOI] [PubMed] [Google Scholar]
  54. Williamson D. F., Madans J., Anda R. F., Kleinman J. C., Giovino G. A., Byers T. Smoking cessation and severity of weight gain in a national cohort. N Engl J Med. 1991 Mar 14;324(11):739–745. doi: 10.1056/NEJM199103143241106. [DOI] [PubMed] [Google Scholar]
  55. Wolk A., Lindblad P., Adami H. O. Nutrition and renal cell cancer. Cancer Causes Control. 1996 Jan;7(1):5–18. doi: 10.1007/BF00115634. [DOI] [PubMed] [Google Scholar]
  56. Wynder E. L., Mabuchi K., Whitmore W. F., Jr Epidemiology of adenocarcinoma of the kidney. J Natl Cancer Inst. 1974 Dec;53(6):1619–1634. [PubMed] [Google Scholar]
  57. Yu M. C., Mack T. M., Hanisch R., Cicioni C., Henderson B. E. Cigarette smoking, obesity, diuretic use, and coffee consumption as risk factors for renal cell carcinoma. J Natl Cancer Inst. 1986 Aug;77(2):351–356. [PubMed] [Google Scholar]
  58. Yuan J. M., Castelao J. E., Gago-Dominguez M., Ross R. K., Yu M. C. Hypertension, obesity and their medications in relation to renal cell carcinoma. Br J Cancer. 1998 May;77(9):1508–1513. doi: 10.1038/bjc.1998.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Zumoff B. Hormonal abnormalities in obesity. Acta Med Scand Suppl. 1988;723:153–160. doi: 10.1111/j.0954-6820.1987.tb05939.x. [DOI] [PubMed] [Google Scholar]

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