gms | German Medical Science

Previous studies suggest that obesity is related to increased risk of renal cell carcinoma (RCC) [Ref. 1]; however, only a few studies report on measures of central versus peripheral adiposity. The aim of our study was to examine the association between anthropometric measures, including waist and hip circumference, and risk of RCC in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC), a large European-wide cohort study.

Our analysis included 348,550 men and women free of cancer at baseline from 8 countries of the EPIC-Study. Mortality data were coded following the rules of the 10th revision of the International Statistical Classification of Diseases, Injuries and Causes of Death (ICD-10), and cancer incidence data following the 2nd revision of the International Classification of Diseases for Oncology (ICD-O-2). Data were coded according to ICD-10/ICD-O-2 as malignant neoplasm of the kidney except pelvis (C64); and malignant neoplasm of the renal pelvis (C65). Height, weight, and waist and hip circumference were measured by trained investigators and lifestyle factors assessed by questionnaires. During 6.0 years of follow-up we identified 287 incident cases of RCC. Relative risks were calculated using Cox regression, stratified by age and study center and adjusted for smoking status, education, alcohol consumption, recreational and household activity, and in women, menopausal status and hormone replacement therapy use.

Among women, an increased risk of RCC was associated with increasing body weight (relative risk in highest vs. lowest quintile, 2.12; 95% confidence interval 1.16-3.88; p trend=0.003), body mass index (2.26; 1.14-4.46; p trend=0.009), waist (1.66; 0.93-2.95; p trend=0.004) and hip circumference (2.27; 1.21-4.28; p trend=0.01); however, the association with waist and hip circumference were attenuated after adjusting for body weight. Among men, hip circumference was significantly related to decreased RCC risk only after accounting for body weight (RR 0.44; 95%-CI 0.20-0.97; p trend=0.03). Height was not significantly related to RCC risk in either men or women.

These findings suggest that obesity is related to an increased risk of RCC irrespective of fat distribution among women, whereas a low hip circumference (a marker of abdominal obesity) is related to an increased RCC risk among men. Our data give further credence to public health efforts aiming to reduce the prevalence of obesity in order to prevent RCC, in addition to other chronic diseases.

The work described in this abstract was carried out with the financial support of the “Europe Against Cancer” Programme of the European Commission (SANCO); Deutsche Krebshilfe; German Cancer Research Center; German Federal Ministry of Education and Research; Danish Cancer Society; Health Research Fund (FIS) of the Spanish Ministry of Health (Network RCESP C03/09); the Spanish Regional Governments of Andalucia, Asturia, Basque Country, Murcia and Navarra; ISCIII, Red de Centros RCESP, C03/09; Cancer Research UK; Medical Research Council, UK; the Stroke Association, UK; British Heart Foundation; Department of Health, UK; Food Standards Agency, UK; the Wellcome Trust, UK; Greek Ministry of Health; Greek Ministry of Education; Italian Association for Research on Cancer; Italian National Research Council; Dutch Ministry of Public Health, Welfare and Sports; National Cancer Registry and the Regional Cancer Registries Amsterdam, East and Maastricht of the Netherlands; World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skåne, Sweden.