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Annals of Oncology Advance Access originally published online on December 8, 2006
Annals of Oncology 2007 18(3):596-600; doi:10.1093/annonc/mdl438
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© 2006 European Society for Medical Oncology

epidemiology

History of treated hypertension and diabetes mellitus and risk of renal cell cancer

A Zucchetto1,*, L Dal Maso1, A Tavani2, M Montella3, V Ramazzotti4, R Talamini1, V Canzonieri5, A Garbeglio6, E Negri2, S Franceschi7 and C La Vecchia2,8

1 S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano (PN)
2 Istituto di Ricerche Farmacologiche "Mario Negri", Milano
3 Servizio di Epidemiologia, Istituto Tumori "Fondazione Pascale", Napoli
4 Servizio Integrato di Epidemiologia e Sistemi Informativi, Istituto Nazionale Tumori "Regina Elena", Roma
5 Divisione di Anatomia Patologica, Centro di Riferimento Oncologico, Aviano (PN)
6 Unità Operativa di Urologia, Azienda Ospedaliera "Santa Maria degli Angeli", Pordenone, Italy
7 International Agency for Research on Cancer, Lyon, France
8 Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milano, Italy

* Correspondence to: Dr A. Zucchetto, Epidemiology and Biostatistics, CRO Aviano, Via Pedemontana Occ. 12, 33081 Aviano (PN), Italy. Tel: +39-0434-659-354; Fax: +39-0434-659-222; E-mail: epidemiology{at}cro.it

Background: An increased risk of renal cell cancer (RCC) has been reported in subjects with hypertension. Whether this association may vary according to sex, smoking, obesity, or RCC clinical presentation is unclear. Results on the link between diabetes mellitus and RCC are inconclusive.

Patients and methods: We conducted an Italian multicenter case–control study, including 767 (494 men, 273 women) incident cases of RCC, under 80 years of age, and 1534 hospital controls, frequency-matched to cases. Multiple logistic regression models, conditioned to center, sex, and age, and adjusted for period of interview, education, smoking, and body mass were used to estimate odds ratios (OR).

Results: Compared with subjects never treated, patients with a history of treated hypertension [OR = 1.7, 95% confidence interval (CI) 1.4–2.1] reported an excess risk of RCC. This pattern was confirmed in different strata of sex, education, smoking habits, body mass, tumor histological type, stage, or grade. The attributable risk of RCC for treated hypertension in this population was 16%. A slight, nonsignificant increased risk was found for history of diabetes mellitus (OR = 1.3, 95% CI 0.9–1.7).

Conclusion: A possible causal role of hypertension in renal cell carcinogenesis is supported by the consistency of the direct association.

Key words: case–control studies, diabetes mellitus, hypertension, renal cell cancer, risk

Received for publication July 24, 2006. Revision received October 23, 2006. Accepted for publication October 30, 2006.


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