Abstract
Objective
Renal cell carcinoma (RCC) incidence is higher among blacks than whites in the United States and has been associated with the frequency and timing of childbirth among women in some epidemiologic studies. We investigated whether reproductive factors are associated with RCC, overall and by race, within a population-based case–control study.
Methods
Between 2002 and 2007, 497 female cases of incident RCC (136 black, 361 white) and 546 female controls (273 black, 273 white) within the Detroit and Chicago metropolitan areas were enrolled. Information on reproductive history and other factors was collected through in-person interviews. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression.
Results
Reduced RCC risk was observed among women aged ≥30 years at first live birth, relative to an age of <20 years (OR 0.5, 95% CI 0.3–0.9). This association was present among both white (OR 0.4, 95% CI 0.2–0.9) and, though not statistically significant, black women (OR 0.6, 95% CI 0.2–1.8). In analyses restricted to clear cell adenocarcinoma, the most common RCC histological subtype, the association was particularly strong (OR 0.3, 95% CI 0.2–0.8). We did not observe clear evidence of association with RCC for other reproductive factors.
Conclusions
Our findings further support an association between late maternal age at first birth and reduced RCC risk, and suggest that the association may be particularly strong for clear cell adenocarcinoma.
Similar content being viewed by others
References
Chow WH, Dong LM, Devesa SS (2010) Epidemiology and risk factors for kidney cancer. Nat Rev Urol 7(5):245–257
Concolino G, Marocchi A, Conti C, Tenaglia R, Di SF, Bracci U (1978) Human renal cell carcinoma as a hormone-dependent tumor. Cancer Res 38(11 Pt 2):4340–4344
Ronchi E, Pizzocaro G, Miodini P, Piva L, Salvioni R, Di FG (1984) Steroid hormone receptors in normal and malignant human renal tissue: relationship with progestin therapy. J Steroid Biochem 21(3):329–335
Reznik-Schuller H (1979) Carcinogenic effects of diethylstilbestrol in male Syrian golden hamsters and European hamsters. J Natl Cancer Inst 62(4):1083–1088
Li JJ, Li SA (1990) Estrogen carcinogenesis in hamster tissues: a critical review. Endocr Rev 11(4):524–531
Cavalieri EL, Kumar S, Todorovic R, Higginbotham S, Badawi AF, Rogan EG (2001) Imbalance of estrogen homeostasis in kidney and liver of hamsters treated with estradiol: implications for estrogen-induced initiation of renal tumors. Chem Res Toxicol 14(8):1041–1050
Chow WH, McLaughlin JK, Mandel JS, Blot WJ, Niwa S, Fraumeni JF Jr (1995) Reproductive factors and the risk of renal cell cancer among women. Int J Cancer 60(3):321–324
Lindblad P, Mellemgaard A, Schlehofer B et al (1995) International renal-cell cancer study. V. Reproductive factors, gynecologic operations and exogenous hormones. Int J Cancer 61(2):192–198
Lambe M, Lindblad P, Wuu J, Remler R, Hsieh CC (2002) Pregnancy and risk of renal cell cancer: a population-based study in Sweden. Br J Cancer 86(9):1425–1429
Kabat GC, Silvera SA, Miller AB, Rohan TE (2007) A cohort study of reproductive and hormonal factors and renal cell cancer risk in women. Br J Cancer 96(5):845–849
Lee JE, Hankinson SE, Cho E (2009) Reproductive factors and risk of renal cell cancer: the Nurses’ Health Study. Am J Epidemiol 169(10):1243–1250
McCredie M, Stewart JH (1992) Risk factors for kidney cancer in New South Wales, Australia. II. Urologic disease, hypertension, obesity, and hormonal factors. Cancer Causes Control 3(4):323–331
Kreiger N, Marrett LD, Dodds L, Hilditch S, Darlington GA (1993) Risk factors for renal cell carcinoma: results of a population-based case-control study. Cancer Causes Control 4(2):101–110
La Vecchia C, Negri E, Franceschi S, Parazzini F (1993) Long-term impact of reproductive factors on cancer risk. Int J Cancer 53(2):215–219
Mellemgaard A, Engholm G, McLaughlin JK, Olsen JH (1994) Risk factors for renal-cell carcinoma in Denmark. III. Role of weight, physical activity and reproductive factors. Int J Cancer 56(1):66–71
Gago-Dominguez M, Castelao JE, Yuan JM, Ross RK, Yu MC (1999) Increased risk of renal cell carcinoma subsequent to hysterectomy. Cancer Epidemiol Biomarkers Prev 8(11):999–1003
Molokwu JC, Prizment AE, Folsom AR (2007) Reproductive characteristics and risk of kidney cancer: Iowa Women’s Health Study. Maturitas 58(2):156–163
Zucchetto A, Talamini R, Dal ML et al (2008) Reproductive, menstrual, and other hormone-related factors and risk of renal cell cancer. Int J Cancer 123(9):2213–2216
Setiawan VW, Kolonel LN, Henderson BE (2009) Menstrual and reproductive factors and risk of renal cell cancer in the Multiethnic Cohort. Cancer Epidemiol Biomarkers Prev 18(1):337–340
Li Y, Graubard BI, DiGaetano R (2011) Weighting methods for population-based case–control studies with complex sampling. J R Stat Soc Ser C 60:1–21
Rust KF, Rao JN (1996) Variance estimation for complex surveys using replication techniques. Stat Methods Med Res 5(3):283–310
Korn EL, Graubard BI (1999) Analysis of health surveys. Wiley, New York
Cantor KP, Lynch CF, Johnson D (1993) Reproductive factors and risk of brain, colon, and other malignancies in Iowa (United States). Cancer Causes Control 4(6):505–511
Clark SL, Cotton DB, Lee W et al (1989) Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 161(6 Pt 1):1439–1442
Ramin SM, Vidaeff AC, Yeomans ER, Gilstrap LC III (2006) Chronic renal disease in pregnancy. Obstet Gynecol 108(6):1531–1539
Lee AJ, Hiscock RJ, Wein P, Walker SP, Permezel M (2007) Gestational diabetes mellitus: clinical predictors and long-term risk of developing type 2 diabetes: a retrospective cohort study using survival analysis. Diabetes Care 30(4):878–883
Wilson BJ, Watson MS, Prescott GJ et al (2003) Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ 326(7394):845
Phipps AI, Buist DS (2009) Validation of self-reported history of hysterectomy and oophorectomy among women in an integrated group practice setting. Menopause 16(3):576–581
Acknowledgments
We thank M. Dunn and K. Torres (Westat, Rockville, MD) for study coordination and S. Munuo (IMS, Silver Spring, MD) for computer support. Financial support: This research was supported by the Intramural Research Program of the National Institutes of Health and the National Cancer Institute under the following contracts: N02-CP-10128 (Westat, Inc.), N02-CP-11004 (Wayne State University), and N02-CP-11161 (University of Illinois at Chicago).
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Purdue, M.P., Colt, J.S., Graubard, B. et al. A case–control study of reproductive factors and renal cell carcinoma among black and white women in the United States. Cancer Causes Control 22, 1537–1544 (2011). https://doi.org/10.1007/s10552-011-9830-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-011-9830-8