Rebecca E Graff1,2, Alejandro Sanchez3, Deirdre K Tobias4,5, Dayron Rodríguez6, Glen W Barrisford7, Michael L Blute6, Yanping Li4, Qi Sun4,8, Mark A Preston9, Kathryn M Wilson1,8, Eunyoung Cho8,10,11. 1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA. 2. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. 3. Department of Urology, Massachusetts General Hospital, Boston, MA asanchez4838@gmail.com. 4. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. 5. Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. 6. Department of Urology, Massachusetts General Hospital, Boston, MA. 7. Department of Urology, Kaiser Permanente, Santa Rosa Medical Center, Santa Rosa, CA. 8. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. 9. Division of Urology, Brigham and Women's Hospital, Boston, MA. 10. Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI. 11. Department of Epidemiology, Brown University School of Public Health, Providence, RI.
Abstract
OBJECTIVE: We assessed whether type 2 diabetes is associated with renal cell carcinoma (RCC), independent of key potential confounders, in two large prospective cohorts with biennially updated covariate data. RESEARCH DESIGN AND METHODS: A total of 117,570 women from the Nurses' Health Study (NHS) and 48,866 men from the Health Professionals Follow-Up Study (HPFS) were followed from 1976 and 1986, respectively, through 2014. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs for associations between type 2 diabetes and pathology-confirmed RCC, overall and by stage, grade, and histologic subtype. RESULTS: During 38 years of follow-up in the NHS, we confirmed 418 RCC case subjects, including 120 fatal cases. Over 28 years in the HPFS, we confirmed 302 RCC case subjects, including 87 fatal cases. Women with type 2 diabetes had a significantly increased risk of RCC compared with women without type 2 diabetes (multivariable HR 1.53; 95% CI 1.14-2.04), with some evidence that the association was stronger for ≤5 (HR 2.15; 95% CI 1.44-3.23) than >5 (HR 1.22; 95% CI 0.84-1.78) years' duration of type 2 diabetes (Pdifference 0.03). Among men, type 2 diabetes was not associated with total RCC (HR 0.89; 95% CI 0.56-1.41) or with RCC defined by stage, grade, or subtype. Sample sizes for analyses by stage, grade, and subtype were limited. CONCLUSIONS: We found that type 2 diabetes was independently associated with a greater risk of RCC in women but not in men.
OBJECTIVE: We assessed whether type 2 diabetes is associated with renal cell carcinoma (RCC), independent of key potential confounders, in two large prospective cohorts with biennially updated covariate data. RESEARCH DESIGN AND METHODS: A total of 117,570 women from the Nurses' Health Study (NHS) and 48,866 men from the Health Professionals Follow-Up Study (HPFS) were followed from 1976 and 1986, respectively, through 2014. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs for associations between type 2 diabetes and pathology-confirmed RCC, overall and by stage, grade, and histologic subtype. RESULTS: During 38 years of follow-up in the NHS, we confirmed 418 RCC case subjects, including 120 fatal cases. Over 28 years in the HPFS, we confirmed 302 RCC case subjects, including 87 fatal cases. Women with type 2 diabetes had a significantly increased risk of RCC compared with women without type 2 diabetes (multivariable HR 1.53; 95% CI 1.14-2.04), with some evidence that the association was stronger for ≤5 (HR 2.15; 95% CI 1.44-3.23) than >5 (HR 1.22; 95% CI 0.84-1.78) years' duration of type 2 diabetes (Pdifference 0.03). Among men, type 2 diabetes was not associated with total RCC (HR 0.89; 95% CI 0.56-1.41) or with RCC defined by stage, grade, or subtype. Sample sizes for analyses by stage, grade, and subtype were limited. CONCLUSIONS: We found that type 2 diabetes was independently associated with a greater risk of RCC in women but not in men.
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