Cancer Research UK : Kidney Cancer risk factors

Kidney Cancer risk factors

This page presents information on risk factors for kidney cancer, including, age and sex, obesity, tobacco smoking, medical conditions and treatment and diet. There is also information on reproductive factors, occupation and family history and previous cancers.

Renal cell carcinoma accounts for the majority of kidney cancers diagnosed in UK adults and will be the main focus of this page. Cancer of the renal pelvis has an aetiology similar to bladder cancer and is covered in bladder cancer risk factors.1

The major risk factors for kidney cancer include age, sex, obesity, smoking, and several genetic and medical conditions. Smoking and obesity are both preventable causes. In Britain smoking has declined in both men and women while the proportion of the population who are obese or overweight is rising.49 So although there may be a reduction in smoking-related kidney cancers there is likely to be a rise in obesity- related cases.

Age and sex and kidney cancer risk

The risk of kidney cancer increases with age: around three-quarters of all cases occur in men and women over the age of 60. The disease is more common in men than in women - three male cases for every two female cases.

Obesity and overweight and kidney cancer risk

Obesity is an established risk factor for kidney cancer.2,3 About 25% of kidney cancer cases in men and 24% in women in the EU are attributable to being overweight.4

A summary analysis of studies published between 1966 and 1998 found that the risk of renal cell cancer increased by 7% for each unit increase of body mass index (BMI), which corresponds to a 35% risk increase for overweight individuals and a 70% risk increase for obese individuals.5

Two cohort studies show a greater risk increase for obese women of about 120%.6,7 There is no consistent link between being overweight and tumours of the renal pelvis.

Tobacco smoking and kidney cancer risk

Cigarette smoking is a major risk factor for renal cell carcinoma and cancer of the renal pelvis.8 It is estimated that 24-32% of renal cell cancer cases in men and 9-16% in women can be attributed to smoking.7,9

On average, current smokers have a 50% increase in risk of kidney cancer.10 Risk increases with the number of cigarettes smoked per day. People who smoke more than 20 cigarettes per day increase their risk by 60-100% compared to non-smokers.11

As a group, former smokers have a 25% higher risk of kidney cancer, 10 but people who have given up for more than 10 years have the same level of risk as life-long non-smokers. Risk for cancer of the renal pelvis is increased by more than three-fold in current smokers.12

Medical conditions and treatment and kidney cancer

Acquired cystic kidney disease, which develops in association with long term kidney problems, is common in dialysis patients, and increases the risk of kidney cancer.13,14 Individuals receiving dialysis have a three- to four-fold increased risk of kidney cancer overall. 15,16

Risk increases with years of dialysis, to almost seven-fold after the tenth year of dialysis. 15,16 Renal transplant patients are at increased risk for cancer in the non-transplanted kidney.13, 17-19

The kidney may receive radiation during radiotherapy for testicular cancer, and the risk of kidney cancer is increased approximately two-fold following radiotherapy for testicular cancer. Risk increases with time since the first cancer, rising to three-fold after thirty years or more.20

Radiotherapy for cervical cancer increases the risk of renal cancer by 30% and again, risk continues to increase with time since treatment, reaching almost two-fold for women who have survived for at least thirty years.21

Although not considered major risk factors, urinary tract infections (UTI), kidney stones, kidney infection and radiation treatment for other cancers have also been positively associated with kidney cancer.13

It has been estimated that 24% of renal cell cancer cases in women and 15% in men are due to hypertension.7 Risk increases by up to two times in men and women with a history of hypertension, with a slightly stronger effect in women than men.7, 12, 22

The kidneys play a vital role in controlling blood pressure by regulating extracellular fluid. When arterial pressure is high, the kidneys increase the rate at which both water and sodium are excreted. This in turn, results in less extracellular fluid and a decrease in blood pressure.

Studies have shown an increased risk with use of diuretics and other anti-hypertensive medication, although it is not possible to say whether the effects are independent of hypertension.7, 23-25

Phenacetin, an analgesic now banned in the UK and throughout Europe, increases the risk of renal pelvis cancer although its effect on renal cell carcinoma is less certain.13 26-28

Diet and risk of kidney cancer

Evidence is growing that there is no overall association between intake of fruits and vegetables and renal cell carcinoma. 29-34 Two cohort studies show a reduced risk of renal cell carcinoma with higher intake of root vegetables.30,32

People drinking more than 15g/day of alcohol have a 30% reduced risk of renal cell cancer.35 One unit, equivalent to a small glass of wine or half a pint of normal strength beer, contains 8 grams of alcohol

Reproductive factors and risk of kidney cancer

Although there is some evidence of an increased risk of kidney cancer with increasing parity,33, 36-39 the results may be confounded by body mass index.38 There is limited evidence for an increased risk after hysterectomy.38-40

Occupation and kidney cancer risk

A recent review concluded that the body of evidence does not support a link between asbestos, petrol or trichloroethylene and kidney cancer.41

Family history and previous cancers and risk of kidney cancer

Siblings of patients with kidney cancer have a four to seven-fold increased risk of being diagnosed with kidney cancer.42-44 Two studies have reported risk ratios of 1.6 and 4.0 for people with a parent diagnosed with kidney cancer, 42-43 although another study did not show an increased risk for parental history.44

People with a previous thyroid cancer have between two and seven times increased risk of kidney cancer.45-47 This may be due to genetic features common to both cancers.48

References for kidney cancer risk factors

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