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Liu Q, Chang X, Lian R, Chen Q, Wang J, Fu S. Evaluation of bi-directional causal association between obstructive sleep apnoea syndrome and diabetic microangiopathy: a Mendelian randomization study. Front Cardiovasc Med 2024; 11:1340602. [PMID: 38784169 PMCID: PMC11112003 DOI: 10.3389/fcvm.2024.1340602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/01/2024] [Indexed: 05/25/2024] Open
Abstract
Background The relationship between obstructive sleep apnea syndrome (OSAS) and diabetic microangiopathy remains controversial. Objective This study aimed to use bidirectional two-sample Mendelian Randomization (MR) to assess the causal relationship between OSAS and diabetic microangiopathy. Methods First, we used the Linkage Disequilibrium Score Regression(LDSC) analysis to assess the genetic correlation. Then, the bidirectional two-sample MR study was conducted in two stages: OSAS and lung function-related indicators (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)) were investigated as exposures, with diabetic microangiopathy as the outcome in the first stage, and genetic tools were used as proxy variables for OSAS and lung function-related measures in the second step. Genome-wide association study data came from the open GWAS database. We used Inverse-Variance Weighted (IVW), MR-Egger regression, Weighted median, Simple mode, and Weighted mode for effect estimation and pleiotropy testing. We also performed sensitivity analyses to test the robustness of the results. Furthermore, we performed multivariate and mediation MR analyses. Results In the LDSC analysis, We found a genetic correlation between OSAS, FVC, FEV 1, and diabetic microangiopathy. In the MR analysis, based on IVW analysis, genetically predicted OSAS was positively correlated with the incidence of diabetic retinopathy (DR), diabetic kidney disease (DKD), and diabetic neuropathy (DN). In the subgroup analysis of DR, there was a significant causal relationship between OSAS and background diabetic retinopathy (BDR) and proliferative diabetic retinopathy (PDR). The reverse MR did not show a correlation between the incidence of diabetic microangiopathy and OSAS. Reduced FVC had a potential causal relationship with increased incidence of DR and PDR. Reduced FEV1 had a potential causal relationship with the increased incidence of BDR, PDR, and DKD. Multivariate MR analysis showed that the association between OSAS and diabetic microangiopathy remained significant after adjusting for confounding factors. However, we did not find the significant mediating factors. Conclusion Our results suggest that OSAS may be a cause of the development of diabetic microangiopathy, and OSAS may also be associated with a high risk of diabetic microangiopathy, providing a reference for a better understanding of the prevention of diabetic microangiopathy.
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Affiliation(s)
- Qianqian Liu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Xingyu Chang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Rongna Lian
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Chen
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Jialei Wang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
| | - Songbo Fu
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Gansu Provincial Endocrine Disease Clinical MedicineResearch Center, Lanzhou, Gansu, China
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Yu L, Yu P, Lu Y. Is hysterectomy associated with kidney cancer risk? A meta-analysis of cohort studies. Front Oncol 2023; 13:1181112. [PMID: 37546408 PMCID: PMC10397505 DOI: 10.3389/fonc.2023.1181112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Emerging evidence have suggested a potential relationship between hysterectomy and risk of kidney cancer with inconsistent results. We aimed to investigate the association of hysterectomy with kidney cancer risk based on a meta-analysis of all available cohort studies. Methods A comprehensive literature search was performed in the PubMed and Embase database, covering all the papers published by September 2022. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a DerSimonian and Laird random effects model. Results Overall, our meta-analysis included 10 cohorts from 9 studies with approximately 240 million participants. The pooled RR with its 95% CI showed a significantly positive association between hysterectomy and risk of kidney cancer (RR 1.30, 95% CI 1.19-1.41). No obvious heterogeneity was observed across the studies (P = 0.206 for heterogeneity; I2 = 25.9%). Conclusion Findings from this meta-analysis of cohort studies indicated that hysterectomy was positively associated with subsequent kidney cancer risk. Further large prospective studies with long-term follow-up are warranted to verify these findings.
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Clasen JL, Mabunda R, Heath AK, Kaaks R, Katzke V, Schulze MB, Birukov A, Tagliabue G, Chiodini P, Tumino R, Milani L, Braaten T, Gram I, Lukic M, Luján‐Barroso L, Rodriguez‐Barranco M, Chirlaque M, Ardanaz E, Amiano P, Manjer J, Huss L, Ljungberg B, Travis R, Smith‐Byrne K, Gunter M, Johansson M, Rinaldi S, Weiderpass E, Riboli E, Cross AJ, Muller DC. Reproductive and hormonal factors and risk of renal cell carcinoma among women in the European Prospective Investigation into Cancer and Nutrition. Cancer Med 2023; 12:15588-15600. [PMID: 37269199 PMCID: PMC10417104 DOI: 10.1002/cam4.6207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) is twice as common among men compared with women, and hormonal factors have been suggested to partially explain this difference. There is currently little evidence on the roles of reproductive and hormonal risk factors in RCC aetiology. MATERIALS & METHODS We investigated associations of age at menarche and age at menopause, pregnancy-related factors, hysterectomy and ovariectomy and exogenous hormone use with RCC risk among 298,042 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. RESULTS During 15 years of follow-up, 438 RCC cases were identified. Parous women had higher rates of RCC compared with nulliparous women (HR = 1.71, 95% CI 1.18, 2.46), and women who were older at age of first pregnancy had lower rates of RCC (30 years + vs. <20 years HR = 0.53, 95% CI 0.34, 0.82). Additionally, we identified a positive association for hysterectomy (HR = 1.43 95% CI 1.09, 1.86) and bilateral ovariectomy (HR = 1.67, 95% CI 1.13, 2.47), but not unilateral ovariectomy (HR = 0.99, 95% CI 0.61, 1.62) with RCC risk. No clear associations were found for age at menarche, age at menopause or exogenous hormone use. CONCLUSION Our results suggest that parity and reproductive organ surgeries may play a role in RCC aetiology.
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Affiliation(s)
- Joanna L. Clasen
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rita Mabunda
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Alicia K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rudolf Kaaks
- Division of Cancer EpidemiologyGerman Cancer research Center (DKFZ)HeidelbergGermany
| | - Verena Katzke
- Division of Cancer EpidemiologyGerman Cancer research Center (DKFZ)HeidelbergGermany
| | - Matthias B. Schulze
- German Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional Science, University of PotsdamNuthetalGermany
| | - Anna Birukov
- German Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- German Center for Diabetes Research (DZD)Muenchen‐NeuherbergGermany
- Department of Nutrition, Harvard T.H. Chan School of Public HealthBostonMassachusettsUnited States
| | | | - Paolo Chiodini
- Medical Statistics UnitUniversity L. VanvitelliNaplesItaly
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research (AIRE ‐ONLUS)RagusaItaly
| | - Lorenzo Milani
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
| | - Tonje Braaten
- Department of Community MedicineUiT The Arctic University of Norway
| | - Inger Gram
- Faculty of Health Sciences, Department of Community MedicineUniversity of Tromsø, The Arctic University of NorwayTromsøNorway
| | - Marko Lukic
- Faculty of Health Sciences, Department of Community MedicineUniversity of Tromsø, The Arctic University of NorwayTromsøNorway
| | - Leila Luján‐Barroso
- Catalan Institute of Oncology (ICO‐IDIBELL), Cancer Epidemiology Research Program, Unit of Nutrition and CancerL'Hospitalet de LlobregatSpain
| | - Miguel Rodriguez‐Barranco
- Escuela Andaluza de Salud Pública (EASP)GranadaSpain
- Instituto de Investigación Biosanitaria ibs.GRANADAGranadaSpain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - María‐Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Department of Epidemiology, Regional Health Council, IMIB‐ArrixacaMurcia UniversityMurciaSpain
| | - Eva Ardanaz
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Navarra Public Health InstitutePamplonaSpain
- IdiSNA, Navarra Institute for Health ResearchPamplonaSpain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of GipuzkoaSan SebastianSpain
- Biodonostia Health Research InstituteEpidemiology of Chronic and Communicable Diseases GroupSan SebastiánSpain
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital MalmöLund UniversityMalmöSweden
| | - Linnea Huss
- Department of Clinical Sciences MalmöLund UniversityMalmöSweden
- Department of SurgeryHelsingborg HospitalHelsingborgSweden
| | - Börje Ljungberg
- Department of Surgical and perioperative sciences, Urology and AndrologyUmeå UniversitySweden
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Karl Smith‐Byrne
- Cancer Epidemiology Unit, Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Marc Gunter
- International Agency for Research on CancerLyonFrance
| | | | | | | | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - David C. Muller
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Epidemiology and Biostatistics, School of Public HealthMRC‐PHE Centre for Environment and Health, Imperial College LondonLondonUK
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Schouten LJ, van de Pol J, Kviatkovsky MJ, van den Brandt PA. Reproductive and external hormonal factors and the risk of renal cell cancer in the Netherlands Cohort Study. Cancer Epidemiol 2022; 79:102171. [DOI: 10.1016/j.canep.2022.102171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/02/2022]
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Purdue MP, Rhee J, Moore L, Gao X, Sun X, Kirk E, Bencko V, Janout V, Mates D, Zaridze D, Petruzella S, Hakimi AA, Linehan WM, Chanock SJ, Brennan P, Furberg H, Troester M, Rothman N. Differences in risk factors for molecular subtypes of clear cell renal cell carcinoma. Int J Cancer 2021; 149:1448-1454. [PMID: 34058014 PMCID: PMC8628648 DOI: 10.1002/ijc.33701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/08/2022]
Abstract
The ccA and ccB molecular subtypes of clear cell renal cell carcinoma (ccRCC) have well-characterized prognostic relevance. However, it is not known whether they possess distinct etiologies. We investigated the relationships between these subtypes and RCC risk factors within a case-control study conducted in Eastern Europe. We analyzed risk factor data for ccA (n = 144) and ccB (n = 106) cases and 1476 controls through case-only and case-control comparisons to assess risk factor differences across subtypes using logistic and polytomous regression models. We also performed a meta-analysis summarizing case-only results from our study and three patient cohorts. Patients with ccB tumors had poorer survival than those with ccA tumors and were more likely to be male (case-only odds ratio [OR] 2.68, 95% confidence interval [CI] 1.43-5.03). In case-control analyses, body mass index was significantly associated with ccA tumors (OR 2.45, 95% CI 1.18-5.10 for ≥35 vs <25 kg/m2 ) but not with ccB tumors (1.52, 0.56-4.12), while trichloroethylene was associated with ccB but not ccA (OR 3.09, 95% CI 1.11-8.65 and 1.25, 0.36-4.39 respectively for ≥1.58 ppm-years vs unexposed). A polygenic risk score of genetic variants identified from genome-wide association studies was associated with both ccA and, in particular, ccB (OR 1.82, 1.11-2.99 and 2.87, 95% CI 1.64-5.01 respectively for 90th vs 10th percentile). In a meta-analysis of case-only results including three patient cohorts, we still observed the ccB excess for male sex and the ccA excess for obesity. In conclusion, our findings suggest the existence of etiologic heterogeneity across ccRCC molecular subtypes for several risk factors.
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Affiliation(s)
- Mark P Purdue
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jongeun Rhee
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lee Moore
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Xiaohua Gao
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Xuezheng Sun
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin Kirk
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Vladimir Bencko
- First Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University, Prague, Czech Republic
| | - Vladimir Janout
- Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic
| | - Dana Mates
- Department of Environmental Health, Institute of Public Health, Bucharest, Romania
| | - David Zaridze
- Institute of Carcinogenesis, Cancer Research Centre, Moscow, Russia
| | - Stacey Petruzella
- Departments of Surgery and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Abraham Ari Hakimi
- Departments of Surgery and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - William Marston Linehan
- Department of Health and Human Services, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer, Lyon, France
| | - Helena Furberg
- Departments of Surgery and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Melissa Troester
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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6
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Peired AJ, Campi R, Angelotti ML, Antonelli G, Conte C, Lazzeri E, Becherucci F, Calistri L, Serni S, Romagnani P. Sex and Gender Differences in Kidney Cancer: Clinical and Experimental Evidence. Cancers (Basel) 2021; 13:cancers13184588. [PMID: 34572815 PMCID: PMC8466874 DOI: 10.3390/cancers13184588] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Kidney cancer is a frequent malignant tumor that accounts for approximately 5% of all cancer incidences. It affects both males and females, but males are twice as likely to develop kidney cancer than females. Evidence shows that this discrepancy takes root in individual differences, such as genetics or pathologies that affect the patient. It is then reflected in the clinical characteristics of the tumors, as males have larger and more aggressive tumors. Understanding the sex- and gender-based differences in kidney cancer is essential to be able to offer patients individualized medicine that would better cover their needs in terms of prevention, diagnosis and treatment. Abstract Sex and gender disparities have been reported for different types of non-reproductive cancers. Males are two times more likely to develop kidney cancer than females and have a higher death rate. These differences can be explained by looking at genetics and genomics, as well as other risk factors such as hypertension and obesity, lifestyle, and female sex hormones. Examination of the hormonal signaling pathways bring further insights into sex-related differences. Sex and gender-based disparities can be observed at the diagnostic, histological and treatment levels, leading to significant outcome difference. This review summarizes the current knowledge about sex and gender-related differences in the clinical presentation of patients with kidney cancer and the possible biological mechanisms that could explain these observations. Underlying sex-based differences may contribute to the development of sex-specific prognostic and diagnostic tools and the improvement of personalized therapies.
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Affiliation(s)
- Anna Julie Peired
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
- Correspondence:
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50134 Florence, Italy; (R.C.); (S.S.)
- Department of Experimental and Clinical Medicine, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Maria Lucia Angelotti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
| | - Giulia Antonelli
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
| | - Carolina Conte
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
| | - Elena Lazzeri
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
| | - Francesca Becherucci
- Nephrology and Dialysis Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50134 Florence, Italy; (R.C.); (S.S.)
- Department of Experimental and Clinical Medicine, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Paola Romagnani
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (M.L.A.); (G.A.); (C.C.); (E.L.); (L.C.); (P.R.)
- Nephrology and Dialysis Unit, Meyer Children’s University Hospital, Viale Pieraccini 24, 50139 Florence, Italy;
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7
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Fuhrman BJ, Moore SC, Byrne C, Makhoul I, Kitahara CM, Berrington de González A, Linet MS, Weiderpass E, Adami HO, Freedman ND, Liao LM, Matthews CE, Stolzenberg-Solomon RZ, Gaudet MM, Patel AV, Lee IM, Buring JE, Wolk A, Larsson SC, Prizment AE, Robien K, Spriggs M, Check DP, Murphy N, Gunter MJ, Van Dusen HL, Ziegler RG, Hoover RN. Association of the Age at Menarche with Site-Specific Cancer Risks in Pooled Data from Nine Cohorts. Cancer Res 2021; 81:2246-2255. [PMID: 33820799 PMCID: PMC8137527 DOI: 10.1158/0008-5472.can-19-3093] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/16/2020] [Accepted: 01/22/2021] [Indexed: 12/24/2022]
Abstract
The average age at menarche declined in European and U.S. populations during the 19th and 20th centuries. The timing of pubertal events may have broad implications for chronic disease risks in aging women. Here we tested for associations of recalled menarcheal age with risks of 19 cancers in 536,450 women [median age, 60 years (range, 31-39 years)] in nine prospective U.S. and European cohorts that enrolled participants from 1981 to 1998. Cox regression estimated multivariable-adjusted HRs and 95% confidence intervals (CI) for associations of the age at menarche with risk of each cancer in each cohort and random-effects meta-analysis was used to generate summary estimates for each cancer. Over a median 10 years of follow-up, 60,968 women were diagnosed with a first primary incident cancer. Inverse linear associations were observed for seven of 19 cancers studied. Each additional year in the age at menarche was associated with reduced risks of endometrial cancer (HR = 0.91; 95% CI, 0.89-0.94), liver cancer (HR = 0.92; 95% CI, 0.85-0.99), melanoma (HR = 0.95; 95% CI, 0.93-0.98), bladder cancer (HR = 0.96; 95% CI, 0.93-0.99), and cancers of the colon (HR = 0.97; 95% CI, 0.96-0.99), lung (HR = 0.98; 95% CI, 0.96-0.99), and breast (HR = 0.98; 95% CI, 0.93-0.99). All but one of these associations remained statistically significant following adjustment for baseline body mass index. Similarities in the observed associations between menarche and seven cancers suggest shared underlying causes rooted early in life. We propose as a testable hypothesis that early exposure to sex hormones increases mid-life cancer risks by altering functional capacities of stem cells with roles in systemic energy balance and tissue homeostasis. SIGNIFICANCE: Age at menarche is associated with risk for seven cancers in middle-aged women, and understanding the shared underlying causal pathways across these cancers may suggest new avenues for cancer prevention.
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Affiliation(s)
- Barbara J Fuhrman
- University of Pittsburgh, Pittsburgh, Pennsylvania.
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Celia Byrne
- Uniformed Health Services University, Bethesda, Maryland
| | - Issam Makhoul
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | | | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hans-Olov Adami
- Harvard T. H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | | | - Mia M Gaudet
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Alpa V Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julie E Buring
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Susanna C Larsson
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anna E Prizment
- Division of Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Kim Robien
- Exercise and Nutrition Sciences, Public Health, George Washington University, Washington, District of Columbia
| | | | - David P Check
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, Rockville, Maryland
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Wilson LF, Tuesley KM, Webb PM, Dixon-Suen SC, Stewart LM, Jordan SJ. Hysterectomy and Risk of Breast, Colorectal, Thyroid, and Kidney Cancer - an Australian Data Linkage Study. Cancer Epidemiol Biomarkers Prev 2021; 30:904-911. [PMID: 33619026 DOI: 10.1158/1055-9965.epi-20-1670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/28/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to investigate the associations between hysterectomy for benign indications and risk of breast, colorectal, kidney, and thyroid cancer, and to explore whether these associations are modified by removal of ovaries at the time of surgery or by age at surgery. METHODS We conducted a retrospective cohort study of the female population of Western Australia (n = 839,332) linking data from electoral, hospital, births, deaths, and cancer records. We used Cox regression to estimate HRs and 95% confidence intervals (CI) for the associations between hysterectomy and diagnosis of breast, colorectal, kidney, and thyroid cancers. RESULTS Compared with no surgery, hysterectomy without oophorectomy (hysterectomy) and hysterectomy with bilateral salpingo-oophorectomy (hysterectomy-BSO) were associated with higher risk of kidney cancer (HR, 1.32; 95% CI, 1.11-1.56 and HR, 1.29; 95% CI, 0.96-1.73, respectively). Hysterectomy, but not hysterectomy-BSO, was related to higher risk of thyroid cancer (HR, 1.38; 95% CI, 1.19-1.60). In contrast, hysterectomy (HR, 0.94; 95% CI, 0.90-0.98) and hysterectomy-BSO (HR, 0.92; 95% CI, 0.85-1.00) were associated with lower risk of breast cancer. We found no association between hysterectomy status and colorectal cancer. CONCLUSIONS The associations between hysterectomy and cancer varied by cancer type with increased risks for thyroid and kidney cancer, decreased risk for breast cancer, and no association for colorectal cancer. IMPACT As breast, colorectal, and gynecologic cancers comprise a sizeable proportion of all cancers in women, our results suggest that hysterectomy is unlikely to increase overall cancer risk; however, further research to understand the higher risk of thyroid and kidney cancer is warranted.
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Affiliation(s)
- Louise F Wilson
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia. .,The University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Australia
| | - Karen M Tuesley
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,The University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Australia
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,The University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Australia
| | - Suzanne C Dixon-Suen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Louise M Stewart
- Health Research and Data Analytics Hub, PHRN Centre for Data Linkage, School of Public Health, Curtin University, Perth, Australia.,Institute for Health Research, University of Notre Dame, Fremantle, Australia
| | - Susan J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,The University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Australia
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9
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Luo J, Rohan TE, Neuhouser ML, Liu N, Saquib N, Li Y, Shadyab AH, Qi L, Wallace RB, Hendryx M. Hysterectomy, Oophorectomy, and Risk of Renal Cell Carcinoma. Cancer Epidemiol Biomarkers Prev 2020; 30:499-506. [PMID: 33335021 DOI: 10.1158/1055-9965.epi-20-1373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/18/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Female hormones may play roles during renal cell carcinoma (RCC) carcinogenesis. The aims of this study were to investigate associations between hysterectomy, oophorectomy, and risk of RCC and to assess whether the associations were modified by exogenous estrogen, commonly used among women who have undergone hysterectomy. METHODS Postmenopausal women (n = 144,599) ages 50-79 years at enrollment (1993-1998) in the Women's Health Initiative were followed for a mean of 15.9 years. Hysterectomy and oophorectomy were self-reported. Incident RCC cases were confirmed by physician review of medical records and pathology reports. Multivariable Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for potential confounders. RESULTS A total of 583 women developed RCC during follow-up. We observed that hysterectomy, regardless of oophorectomy status, was significantly associated with an increased risk of RCC (HR, 1.28; 95% CI, 1.03-1.60). The association appeared to be more pronounced in women with age at hysterectomy younger than 40 years (HR, 1.34; 95% CI, 1.01-1.80) or older than 55 years (HR, 1.52; 95% CI, 1.01-2.29). Oophorectomy was not significantly associated with risk of RCC. There was no evidence that exogenous estrogen use modified the association between hysterectomy and risk of RCC. CONCLUSIONS In this large prospective study, we showed that women with a history of hysterectomy had 28% increased risk of RCC, and this finding was not modified by exogenous hormone use. IMPACT If our findings are confirmed, women should be made aware of increased risk of RCC when considering hysterectomy.
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Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana.
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nianjun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| | - Nazmus Saquib
- Research unit, College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
| | - Yueyao Li
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, California
| | - Lihong Qi
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, California
| | | | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, Indiana
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10
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Zhang X, Du Y, Tan X, Wang H, Li Y, Zhang Z, Wang A. The Relationship Between Hormone Replacement Therapy and Risk of Kidney Cancer in Women: A Meta-Analysis. Cancer Control 2020; 27:1073274820930194. [PMID: 32668959 PMCID: PMC7366413 DOI: 10.1177/1073274820930194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Results from the epidemiologic studies on the relationship between hormone replacement therapy (HRT) and the risk of kidney cancer in women were not completely consistent. This meta-analysis aimed to evaluate the relationship between HRT and risk of kidney cancer in women. We performed a meta-analysis of observational studies to assess this association. The PubMed and Embase databases were searched from their inception to January 29, 2020, to identify relevant studies that fit the pre-stated inclusion criteria; reference lists from the retrieved articles were also been reviewed. Relative risks (RRs) with corresponding 95% CIs were extracted and combined using random effects models. Furthermore, dose-response, sensitivity analyses, publication bias, and subgroup analysis by study design, regional location, and exposure assessment method were conducted. Thirteen articles involving 6 cohort studies and 8 case-control studies were included in our meta-analysis. Overall, 4194 women were diagnosed with kidney cancer among 648 107 participants. The pooled RR for kidney cancer was 1.08 (95% CI: 0.96-1.22) in those who were administered HRT compared to those who had not. Subgroup analysis indicated the overall result was not influenced by study type, regional location, or adjusted variables. Dose-response analysis showed a nonlinear relationship between HRT and kidney cancer (P = .0021) and the risk of kidney cancer decreased by 15% to 28% with 12 to 18 years of HRT use. No evidence of publication bias was found (P for Egger =.111). Our meta-analysis showed that HRT use is inversely associated with kidney cancer risk in a dose-dependent fashion.
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Affiliation(s)
- Xiaojun Zhang
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yuelin Du
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xiaojun Tan
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Hui Wang
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yunxiang Li
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Zongping Zhang
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Anguo Wang
- Department of Urology Surgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan, China
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11
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Deli T, Orosz M, Jakab A. Hormone Replacement Therapy in Cancer Survivors - Review of the Literature. Pathol Oncol Res 2019; 26:63-78. [PMID: 30617760 PMCID: PMC7109141 DOI: 10.1007/s12253-018-00569-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022]
Abstract
Rapid advance in oncology leads to increasing survival of oncologic patients. More and more of them live long enough to reach either the natural age of menopause or, as a side effect of their oncotherapy, experience the cessation of gonadal function, leading to premature ovarian insufficiency, with disturbing vasomotor symtoms and long-term negative cardiovascular and skeletal effects. Thus, an ever increasing number of cancer survivors search endocrinologic help in the form of hormone replacement therapy (HRT). The misinterpretation of the WHI (Women's Health Initiative) Study has lead to an irrational fear of female hormone replacement, both by the general population and medical professionals. It has seemed the logical and safe conclusion to many physicians to avoid HRT, supposing that this attitude definitely causes no harm, whereas the decision of prescribing estrogen alone or with progestins might bear oncologic and thromboembolic risks and may even lead to litigation in case of a potentially related complication. However, it was known even before the WHI results that premature menopause and hypogonadism decreases the life expectancy of women by years through its skeletal and cardiovascular effects, and this negative effect correlates with the length of the hypoestrogenaemic period. Therefore, the denial of HRT also needs to be supported by evidence and should be weighed againts the risks of HRT. Yet, the oncologic risk of HRT is extremely difficult to assess. In this work we review the latest evidence from in vitro experiments to clinical studies, regarding HRT in survivors of gynecologic and non-gynecologic cancers. Based on our literature research, we group tumours regarding the oncologic risk of properly chosen female hormone replacement therapy in cancer survivors as follows: ’HRT is advanageous’ (e.g. endometrial cancer type I, cervical adenocarcinoma, haematologic malignancies, local cutaneous malignant melanoma, colorectal cancer, hepatocellular cancer); ’HRT is neutral’ (e.g. BRCA 1/2 mutation carriers without cancer, endometrial cancer type II, uterinal carcinosarcoma and adenosarcoma, certain types of ovarian cancer, cervical, vaginal and vulvar squamous cell carcinoma, prolactinoma, kidney cancer, pancreatic cancer, thyroid cancer); ’HRT is relatively contraindicated’ for various reasons (e.g. leiomyosarcoma, certain types of ovarian tumours, brain tumours, advanced metastatic malignant melanoma, lung cancer, gastric cancer, bladder cancer); ’HRT is diasadvantageous and thus contraindicated’ (e.g. breast cancer, endometrial stroma sarcoma, meningioma, glioma, hormone receptor positive gastric and bladder cancer).
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Affiliation(s)
- Tamás Deli
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Mónika Orosz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Jakab
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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12
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Williams WV, Mitchell LA, Carlson SK, Raviele KM. Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer. LINACRE QUARTERLY 2019; 85:412-452. [PMID: 32431377 DOI: 10.1177/0024363918811637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Combined estrogen-progestogen contraceptives (oral contraceptives or OCs) and progestogen-only contraceptives (POCs) are synthetic steroids that bind to steroid hormone receptors, which are widespread throughout the body. They have a profound effect on cellular physiology. Combined OCs have been classified by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens, but their findings have not been updated recently. In order to update the information and better understand the impact that OCs and POCs have on the risk of development of cancers, a comprehensive literature search was undertaken, focusing on more recently published papers. In agreement with the IARC, the recent literature confirms an increased risk of breast cancer and cervical cancer with the use of OCs. The recent literature also confirms the IARC conclusion that OCs decrease the risk of ovarian and endometrial cancers. However, there is little support from recent studies for the IARC conclusion that OCs decrease the risk of colorectal cancer or increase the risk of liver cancer. For liver cancer, this may be due to the recent studies having been performed in areas where hepatitis is endemic. In one large observational study, POCs also appear to increase the overall risk of developing cancer. OCs and POCs appear to increase the overall risk of cancer when carefully performed studies with the least intrinsic bias are considered. Summary OCs have been classified as cancer-causing agents, especially leading to increases in breast cancer and cervical cancer. A review of the recent scientific literature was performed to see whether this still appears to be the case. The recent literature supports the cancer-causing role of OCs especially for breast cancer and cervical cancer. Studies also indicate that progesterone-only contraceptives (such as implants and vaginal rings) also can cause cancer. This is especially true for breast cancer and cervical cancer.
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Affiliation(s)
- William V Williams
- BriaCell Therapeutics Corporation, West Vancouver, British Columbia, Canada.,University of Pennsylvania, Philadelphia, PA, USA
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13
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Liu X, Sun Q, Hou H, Zhu K, Wang Q, Liu H, Zhang Q, Ji L, Li D. The association between BMI and kidney cancer risk: An updated dose-response meta-analysis in accordance with PRISMA guideline. Medicine (Baltimore) 2018; 97:e12860. [PMID: 30383638 PMCID: PMC6221676 DOI: 10.1097/md.0000000000012860] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Obesity is considered as one of the risk factors of kidney cancer. However, the results are not consistent in reported original studies, as well as in published meta-analysis. This study aims to clarify the relationship between overweight/obesity and kidney cancer by an updated overall and dose-response meta-analysis. METHODS This meta-analysis was conducted in accordance with PRISMA guideline. Relevant studies were searched using PubMed, Embase, and Web of Science databases. The studies were limited to human cohort studies in English and Chinese language. Random-effect models and dose-response meta-analysis were used to synthesize the results. Subgroup analyses were also conducted based on the characteristics of participants. RESULTS Twenty-four cohort studies with 8,953,478 participants were included in our meta-analysis. Compared to the normal weight, the pooled RRs of kidney cancer was 1.35 (1.27-1.43) in overweight and 1.76 (1.61-1.91) in obese participants. An increased kidney cancer risk of 1.06 (1.05-1.06) for each 1 kg/m increase in BMI was showed in dose-response meta-analysis. No significant heterogeneity was found across studies with I = 39.4% for overweight, and I = 43.3% for obesity. CONCLUSION The overall and dose-response meta-analysis suggested that overweight/obesity increases the risk of kidney cancer both in men and women.
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Affiliation(s)
- Xuezhen Liu
- School of Public Health, Taishan Medical University
| | - Qi Sun
- Traditional Chinese Medical Hospital of Taian, Tai’an, China
| | - Haifeng Hou
- School of Public Health, Taishan Medical University
| | - Kai Zhu
- School of Public Health, Taishan Medical University
| | - Qian Wang
- School of Public Health, Taishan Medical University
| | - Huamin Liu
- School of Public Health, Taishan Medical University
| | | | - Long Ji
- School of Public Health, Taishan Medical University
| | - Dong Li
- School of Public Health, Taishan Medical University
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14
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Michels KA, Brinton LA, Pfeiffer RM, Trabert B. Oral Contraceptive Use and Risks of Cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol 2018; 187:1630-1641. [PMID: 29394309 DOI: 10.1093/aje/kwx388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/21/2017] [Indexed: 12/23/2022] Open
Abstract
Although use of oral contraceptives (OCs) is common, their influence on carcinogenesis is not fully understood. We used Cox proportional hazards models to examine OC use (never/<1 year (referent), 1-4, 5-9, ≥10 years) and development of incident cancers across body sites within the same base population: women in the prospective National Institutes of Health-AARP Diet and Health Study (enrolled 1995-1996 and followed until 2011). Adjustment for confounding varied by outcome; all models accounted for age, race, body mass index, and smoking status, and included at least 100,000 women. Any OC use conferred a 3% reduction in the risk for any cancer (hazard ratio = 0.97, 95% confidence interval: 0.95, 0.99). Expected risk reductions that strengthened with duration of use were identified for ovarian and endometrial cancers and were suggested for kidney cancer (all P for trend < 0.05). Non-Hodgkin lymphoma risk (hazard ratio = 0.79, 95% confidence interval: 0.64, 0.97) was reduced with 10 or more years of OC use. There was a 37% reduced risk for bladder cancer and 46% increased risk for pancreatic cancer among long-term OC users who were 60 years of age or younger at baseline. OC use did not influence risks for most other cancers evaluated. Given the high prevalence of use and changing formulations, additional studies are warranted to fully understand the chemopreventive effects of these medications.
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Affiliation(s)
- Kara A Michels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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15
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David RA, Idowu B, Akindiose C, Laoye A, Aluko JA, Omisore AD, Alajiki E, Komolafe AO, Salako AA, Onwudiegwu U. Peculiarities and management challenges of advanced renal cell carcinoma incidentally discovered in pregnancy. Clin Case Rep 2018; 6:863-866. [PMID: 29744074 PMCID: PMC5930196 DOI: 10.1002/ccr3.1485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 02/18/2018] [Indexed: 12/21/2022] Open
Abstract
Our aim is that urologists, gynecologists, nephrologists, and general practitioners will be reminded that diagnosis of renal malignancies sometimes require a high index of suspicion as they may remain asymptomatic in advanced stages; even as they can also rarely co‐exist with and cause peculiar challenges in pregnancy.
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Affiliation(s)
- Rotimi A David
- Urology Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Boluwatife Idowu
- Department of Obstetrics and Gynaecology Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Cathlyn Akindiose
- General Surgery Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Adeyinka Laoye
- Urology Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - John A Aluko
- Department of Morbid Anatomy Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Adeleye D Omisore
- Department of Radiology Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Emmanuel Alajiki
- Department of Obstetrics and Gynaecology Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Akinwumi O Komolafe
- Department of Morbid Anatomy Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Abdulkadir A Salako
- Urology Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Uchenna Onwudiegwu
- Department of Obstetrics and Gynaecology Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
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16
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Khaled H, Lahloubi NA, Rashad N. Review on renal cell carcinoma and pregnancy: A challenging situation. J Adv Res 2016; 7:575-80. [PMID: 27408760 PMCID: PMC4921780 DOI: 10.1016/j.jare.2016.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 12/15/2022] Open
Abstract
Renal cell carcinoma is rarely diagnosed during pregnancy. Its management is a real challenge due to the sparse literature and lack of standard guidelines. In this situation, the diagnosis is often delayed as the clinical presentation might resemble other pregnancy-related disorders but it should be one of the diagnostic possibilities in women with recurrent or refractory urinary tract symptoms, renal pain, or mass that could be palpated. Diagnostic approach may include ultrasound examination and sometimes magnetic resonance imaging. If localized, surgery would be the preferred line of treatment. Other treatment modalities, end results of treatment, and review of literature of this rare association will be presented.
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Affiliation(s)
- Hussein Khaled
- Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt
| | - Nasr Al Lahloubi
- Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt
| | - Noha Rashad
- Department of Medical Oncology, Military Armed Hospital Caner Center, Cairo, Egypt
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17
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Murray KS, Zabor EC, Spaliviero M, Russo P, Bazzi WM, Musser JE, Ari Hakimi A, Bernstein ML, Dalbagni G, Coleman JA, Furberg H. Second primary malignancies in renal cortical neoplasms: an updated evaluation from a single institution. World J Urol 2016; 34:1667-1672. [PMID: 27106493 DOI: 10.1007/s00345-016-1832-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/12/2016] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To examine the incidence of secondary primary malignancies in patients with renal cortical neoplasms. METHODS Between January 1989 and July 2010, 3647 patients underwent surgery at our institution for a renal cortical neoplasm and were followed through 2012. Occurrence of other malignancies was classified as antecedent, synchronous, or subsequent. All patients with antecedent malignancies (n = 498) and a randomly selected half of those with synchronous malignancies (n = 83) were excluded. The expected number of second primaries was calculated by multiplying Surveillance, Epidemiology, and End Results Program incidence rates of renal cortical neoplasms by person-years at risk within categories of age, sex, and year of diagnosis. The standardized incidence ratio (SIR) was calculated as observed cancers divided by expected incidence of the cancer, with approximation to the exact Poisson test used to obtain confidence intervals (CI) and p values. RESULTS Of 3066 patients with renal cortical neoplasms, 267 had a second primary cancer; the five most common in men were prostate, colorectal, bladder, lung, and non-Hodgkin's lymphoma; the five most common in women were breast, colorectal, lung, endometrium, and thyroid. Men demonstrated higher than expected thyroid cancer rate (SIR 5.0; 95 % CI 1.83-10.88, p = 0.002), and women had higher than expected rates of stomach cancer (SIR 5.0; 95 % CI 1.61-11.67, p = 0.004) and thyroid cancer (SIR 4.62; 95 % CI 1.69-10.05, p = 0.003). CONCLUSIONS The incidence of certain types of second malignancies may be higher in patients after diagnosis of renal cortical neoplasms compared to the general population. These observations can inform clinical follow-up in kidney cancer survivorship and future research studies.
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Affiliation(s)
- Katie S Murray
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
| | - Emily C Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Massimiliano Spaliviero
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
| | - Wassim M Bazzi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - John E Musser
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
| | - Melanie L Bernstein
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Guido Dalbagni
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
| | - Helena Furberg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
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18
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Abolhasani M, Salarinejad S, Asgari M. P53 and MDM2 Over-expression and Five-year Survival of Kidney Cancer Patients Undergoing Radical Nephrectomy--Iranian Experience. Asian Pac J Cancer Prev 2016; 16:5043-7. [PMID: 26163638 DOI: 10.7314/apjcp.2015.16.12.5043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatively little is known with certainty about the status and role of p53 or MDM2 in predicting prognosis and survival of renal cell carcinoma. The present study aimed to determine the value of P53 and MDM2 over-expression, alone and simultaneously, to predict five-year survival of patients with kidney cancer in Iran. MATERIALS AND METHODS Patients with kidney cancer referred to Hasheminejad Kidney Center between 2007 and 2009, underwent radical nephrectomy and had pathology reports of clear cell, papillary or chromophobe renal cell carcinoma were included in our cohort study. Other histological types of renal cell carcinoma were not included. The patients with missed, incomplete or poor quality paraffin blocks were also excluded. Overall ninety one patients met the inclusion and exclusion criteria. To assess the histopathological features of the tumor, immunohistochemical (IHC) staining of formalin fixed, paraffin-embedded tumor samples were performed. The five-year survival was determined by the patients' medical files and telephone following-up. RESULTS In total, 1.1% of all samples were revealed to be positive for P53. Also, 20.8% of all samples were revealed to be positive for MDM2.The patients were all followed for 5 years. In this regard, 5-year mortality was 30.5% and thus 5-year survival was 85.3%. According to the Cox proportional hazard analysis, positive P53 marker was only predictor for patients' 5-year survival that the presence of positive p53 increased the risk for long-term mortality up to 2.8 times (HR=2.798, 95%CI: 1.176-6.660, P=0.020). However, the presence of MDM2 could not predict long-term mortality. In this regard, analysis by the ROC curve showed a limited role for predicting long-term survival by confirming P53 positivity (AUC=0.610, 95%CI: 0.471-.750, P=0.106). The best cutoff point for P53 to predict mortality was 0.5 yielding a low sensitivity (32.0%) but a high specificity (97.9%). In similar analysis, measurement of MDM2 positivity could not predict mortality (AUC=0.449, 95%CI: 0.316-.583, P=0.455). CONCLUSIONS The simultaneous presence of both P53 and MDM2 markers in our population is a rare phenomenon and the presence of these markers may not predict long-term survival in patients who undergoing radical nephrectomy.
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Affiliation(s)
- Maryam Abolhasani
- Oncopathology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran E-mail :
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Ho WJ, Simon MS, Yildiz VO, Shikany JM, Kato I, Beebe-Dimmer JL, Cetnar JP, Bock CH. Antioxidant micronutrients and the risk of renal cell carcinoma in the Women's Health Initiative cohort. Cancer 2015; 121:580-8. [PMID: 25302685 PMCID: PMC5078985 DOI: 10.1002/cncr.29091] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND Renal cell carcinoma (RCC) is the eighth leading cancer among women in incidence and commonly is diagnosed at a more advanced stage. Oxidative stress has been considered to play an important role in the pathogenesis of RCC. Various dietary micronutrients have antioxidant properties, including carotenoids and vitamins C and E; thus, diets rich in these nutrients have been evaluated in relation to RCC prevention. The objective of this study was to explore the correlation between antioxidant micronutrients and the risk of RCC. METHODS In total, 96,196 postmenopausal women who enrolled in the Women's Health Initiative (WHI) between 1993 and 1998 and were followed through July 2013 were included in this analysis. Dietary micronutrient intake was estimated from the baseline WHI food frequency questionnaire, and data on supplement use were collected using an interview-based inventory procedure. RCC cases were ascertained from follow-up surveys and were centrally adjudicated. The risks for RCC associated with intake of α-carotene, β-carotene, β-cryptoxanthin, lutein plus zeaxanthin, lycopene, vitamin C, and vitamin E were analyzed using Cox proportional hazards regression adjusted for confounders. RESULTS Two hundred forty women with RCC were identified during follow-up. Lycopene intake was inversely associated with RCC risk (P = .015); compared with the lowest quartile of lycopene intake, the highest quartile of intake was associated with a 39% lower risk of RCC (hazard ratio, 0.61; 95% confidence interval, 0.39-0.97). No other micronutrient was significantly associated with RCC risk. CONCLUSIONS The current results suggest that further investigation into the correlation between lycopene intake and the risk of RCC is warranted.
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Affiliation(s)
- Won Jin Ho
- Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Michael S. Simon
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
| | - Vedat O. Yildiz
- Center for Biostatistics, Ohio State University, Columbus, Ohio
| | - James M. Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ikuko Kato
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
| | | | - Jeremy P. Cetnar
- Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin
| | - Cathryn H. Bock
- Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
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Liu H, Wang XC, Hu GH, Huang TB, Xu YF. Oral contraceptive use and kidney cancer risk among women: evidence from a meta-analysis. Int J Clin Exp Med 2014; 7:3954-3963. [PMID: 25550903 PMCID: PMC4276161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/30/2014] [Indexed: 06/04/2023]
Abstract
Previous studies have investigated the relationship between oral contraceptives (OCs) use and kidney cancer risk. However, they yielded inconsistent results. To our knowledge, a comprehensive assessment of the association between OC and kidney cancer risk has not been reported. Hence, we conducted a meta-analysis to quantify the association. We identified all relevant studies up to July 2014 through a literature search of using PubMed and EMBASE, and by reviewing the references from the retrieved articles. Fixed-effect and random-effect models were used to estimate summary relative risks (SRRs) and the corresponding 95% confidence intervals (CIs). A total of 12 studies were eligible and included in this meta-analysis, involving 4,206 kidney cancer cases and 638,677 participants. The SRR of kidney cancer for ever versus never OC use was 0.89 (95% CI: 0.82-0.98). The protection became stronger when compared the longest duration of OC use with never use (RR = 0.80; 95% CI: 0.68-0.94). In dose-response analysis, we found that the kidney cancer risk decreased by 2% for per 1 year increment in OC use (RR = 0.98; 95% CI: 0.96-0.99). No apparent heterogeneity was observed across studies included in this analysis. Egger's and Begg's test also indicated no publication bias. The present study suggested that OC may reduce the risk of kidney cancer, especially for long-term users. More well-conducted and large-scale prospective studies are warranted to confirm the effects of OC use on kidney cancer.
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Affiliation(s)
- Huan Liu
- Department of Urology, Shanghai Tenth People’s HospitalTongji University, Shanghai, China
- Department of First Clinical Medical College, Nanjing Medical UniversityNanjing, Jiangsu, China
| | - Xing-Chun Wang
- Department of Urology, Shanghai Tenth People’s HospitalTongji University, Shanghai, China
- Department of First Clinical Medical College, Nanjing Medical UniversityNanjing, Jiangsu, China
| | - Guang-Hui Hu
- Department of Urology, Shanghai Tenth People’s HospitalTongji University, Shanghai, China
| | - Tian-Bao Huang
- Department of Urology, Shanghai Tenth People’s HospitalTongji University, Shanghai, China
- Department of First Clinical Medical College, Nanjing Medical UniversityNanjing, Jiangsu, China
| | - Yun-Fei Xu
- Department of Urology, Shanghai Tenth People’s HospitalTongji University, Shanghai, China
- Department of First Clinical Medical College, Nanjing Medical UniversityNanjing, Jiangsu, China
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Wang F, Xu Y. Body mass index and risk of renal cell cancer: a dose-response meta-analysis of published cohort studies. Int J Cancer 2014; 135:1673-86. [PMID: 24615287 DOI: 10.1002/ijc.28813] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 02/17/2014] [Indexed: 12/31/2022]
Abstract
Obesity is accepted as one of the major risk factors for renal cell cancer (RCC). However, conflicting results persist for the pooled risks based on the results from case-control and cohort studies combined, and the exact shape of the dose-response relationship has not been clearly defined yet. To help elucidate the role of obesity, PubMed and Embase databases were searched for published cohort studies on associations between body mass index (BMI) and risk of RCC. Random-effects models and dose-response meta-analyses were used to pool study results. Subgroup analyses were conducted by the available characteristics of studies and participants. Cohort studies (21) with 15,144 cases and 9,080,052 participants were identified. Compared to normal weight, the pooled relative risks and the corresponding 95% confidence intervals of RCC were 1.28(1.24-1.33) for preobesity and 1.77(1.68-1.87) for obesity, respectively. A nonlinear dose-response relationship was also found for RCC risk with BMI (p = 0.000), and the risk increased by 4% for each 1 kg/m(2) increment in BMI. There was no significant between-study heterogeneity among studies (I(2) = 35.6% for preobesity and I(2) = 44.2% for obesity, respectively). Subgroup analysis showed a basically consistent result with the overall analysis. These results suggest that increased BMI are associated with increased risk of RCC both for men and women.
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Affiliation(s)
- Furan Wang
- Department of Pediatric Urology, Ningbo Women & Children's Hospital, Ningbo, Zhejiang, China
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Karami S, Daugherty SE, Purdue MP. Hysterectomy and kidney cancer risk: a meta-analysis. Int J Cancer 2014; 134:405-10. [PMID: 23818138 PMCID: PMC3834077 DOI: 10.1002/ijc.28352] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 06/05/2013] [Accepted: 06/12/2013] [Indexed: 12/25/2022]
Abstract
Recent cohort findings suggest that women who underwent a hysterectomy have an elevated relative risk of kidney cancer, although evidence from past studies has been inconsistent. We conducted a systematic review and meta-analysis of published cohort and case-control studies to summarize the epidemiologic evidence investigating hysterectomy and kidney cancer. Studies published from 1950 through 2012 were identified through a search of PubMed and of references from relevant publications. Meta-analyses were conducted using random-effects models to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for hysterectomy, age at hysterectomy (<45, 45+ years) and time since hysterectomy (<10, 10+ years). The SRR for hysterectomy and kidney cancer for all published studies (seven cohort, six case-control) was 1.29 (95% CI, 1.16-1.43), with no evidence of between-study heterogeneity or publication bias. The summary effect was slightly weaker, although still significant, for cohorts (SRR, 1.26; 95% CI, 1.11-1.42) compared with case-control findings (1.37; 95% CI, 1.09-1.73) and was observed irrespective of age at hysterectomy, time since the procedure and model adjustment for body mass index, smoking status and hypertension. Women undergoing a hysterectomy have an approximate 30% increased relative risk of subsequent kidney cancer. Additional research is needed to elucidate the biological mechanisms underlying this association.
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Affiliation(s)
- Sara Karami
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Sarah E. Daugherty
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Department of Health and Human Services, Bethesda, Maryland
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Guan HB, Wu QJ, Gong TT. Parity and kidney cancer risk: evidence from epidemiologic studies. Cancer Epidemiol Biomarkers Prev 2013; 22:2345-53. [PMID: 24108791 DOI: 10.1158/1055-9965.epi-13-0759-t] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Observational studies have reported conflicting results between parity and kidney cancer risk. To our knowledge, a comprehensive and quantitative assessment of the association between parity and kidney cancer has not been reported. Thus, we conducted a systematic review and dose-response meta-analysis of published epidemiologic studies to summarize the evidence of this association. METHODS Relevant published studies of parity and kidney cancer were identified using MEDLINE (PubMed) database through end of June 2013. Two authors independently assessed eligibility and extracted data. Six prospective and eight case-control studies reported relative risk (RR) estimates and 95% confidence intervals (CI) of kidney cancer associated with parity or parity number. Fixed- or random-effects models were used to estimate summary relative risk. RESULTS The summary relative risk of kidney cancer for the parity versus nulliparous was 1.23 (95% CI, 1.10-1.36; Q = 12.41; P = 0.413; I(2) = 3.3%). In addition, significant association was also found for the highest versus lowest parity number, with summary RR = 1.36 (95% CI, 1.19-1.56; Q = 8.24; P = 0.766; I(2) = 0%). In the dose-response analysis, the summary per one live birth relative risk was 1.08 (95% CI: 1.05-1.10; Q = 9.34; P = 0.500; I(2) = 0%), also indicating the positive effect of parity on kidney cancer risk. No evidence of publication bias and significant heterogeneity between subgroups was detected by meta-regression analyses. CONCLUSIONS In summary, findings from this meta-analysis suggest that ever parity and higher parity number is significantly associated with increased risk of kidney cancer. IMPACT The present results suggest a positive association between parity and kidney cancer risk.
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Affiliation(s)
- Hong-Bo Guan
- Authors' Affiliations: Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang; Department of Epidemiology; and State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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