THE EPIDEMIOLOGY OF RENAL-CELL CARCINOMA - A 2ND LOOK

Background. From 1973 to 1991, the incidence of kidney cancer in the U nited States increased by 35.4%. Methods. A multicenter, hospital-base d case-control study was conducted from 1977 to 1993 through an interv iew of 788 patients with renal cell carcinoma and 779 control subjects . Results. Compared with those who never smoked, the odds ratio (OR) f or renal cell carcinoma among current cigarette smokers was 1.4 (95% c onfidence interval [CI] 1.02-2.0) for men and 1.1 (95% CI 0.7-1.6) for women. Among men, there was a rising trend in the odds ratios with in creasing pack-years of smoking (P < 0.01) but not with the number of c igarettes smoked per day. The OR among those currently smoking nonfilt er cigarettes exclusively was 2.4 (95% CI 1.2-4.9) for men and 2.0 (95 % CI 0.4-11.1) for women. No increased risk was observed among current smokers of filter cigarettes. Among men, the OR associated with chewi ng tobacco was 3.2 [95% CI 1.1-8.7). Total alcohol consumption was unr elated to the risk of renal cell carcinoma. A joint effect was observe d among subjects with a high body mass index who reported a history of hypertension (OR = 1.9, 95% CI 1.01-3.5) for men and 3.2 (95% CI 1.3- 7.7) for women. Conclusion. High body weight and hypertension were rel ated jointly to renal cell carcinoma. Smoking nonfilter cigarettes and long term cigarette smoking (greater than or equal to 30 years) was a predictor for renal cell carcinoma risk in men. No significant associ ation was found between smoking and renal cell carcinoma in women.