Obesity, Hyperglycemia Potentiate Family History’s Effect on Kidney Cancer Risk

Familial risk of RCC decreased minimally after adjustment for obesity and hyperglycemia, indicating that genetic predisposition is the main RCC risk factor, investigators reported.

Renal cell carcinoma (RCC) is more likely to develop among individuals with first-degree relatives affected by cancer, with obesity and hyperglycemia further increasing the risk, according to a recent study.

“Obese or hyperglycemic individuals with a family history should be considered a high-risk population and screening should be recommended, especially for those in younger age groups,” investigators concluded.

Among 5,524,403 Korean individuals with National Health Insurance from 2002 to 2018, a total of 21,085 (male: 15,163, female: 5912) were diagnosed with RCC.

During follow-up, new RCC cases occurred in 57 first-degree relatives of those affected and 3433 individuals without affected relatives. The incidence of familial and non-familial RCC was 1.03 vs 0.35 cases per 10,000 person-years, respectively.

The risk for RCC was 2.3-fold higher among individuals with vs without affected first-degree relatives after adjustment for age, sex, and lifestyle factors, corresponding author Hyeong Sik Ahn, MD, PhD, of Korea University in Seoul, Korea, and colleagues reported in The Journal of Urology. Familial risk was highest for individuals with an affected sibling, followed by an affected father or mother (a 2.7-, 2.3-, and 2.1-fold adjusted risk increase, respectively).

Obesity and hyperglycemia were each associated with a 1.7- and 1.2-fold increased risk for RCC, respectively, compared with a reference group with no lifestyle factors or family history. The presence of a family history of RCC together with either hyperglycemia or obesity increased the risks for RCC 4.5- and 3.7-fold, respectively. The investigators did not assess the risk of RCC with all 3 risk factors.

“The combined risk of obesity/hyperglycemia with family history exceeded the sum of their individual risks,” Dr Ahn’s team wrote. “This finding suggests that genetic factors and obesity/hyperglycemia potentiate each other’s effects in the carcinogenesis of RCC.”

Reference

Lee SW, Kim HJ, Kazmi SZ, et al. Familial risk of renal cell cancer and interaction with obesity and hyperglycemia — a population-based study. J Urol. Published online March 17, 2022. doi:10.1097/JU.0000000000002506