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Association of kidney function with cancer incidence and its influence on cancer risk of smoking: The Japan Multi-Institutional Collaborative Cohort Study |
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| Authors: | Shimon Kurasawa Takahiro Imaizumi Shoichi Maruyama Keitaro Tanaka Yoko Kubo Mako Nagayoshi Hiroaki Ikezaki Sadao Suzuki Teruhide Koyama Chihaya Koriyama Aya Kadota Sakurako Katsuura-Kamano Kiyonori Kuriki Kenji Wakai Keitaro Matsuo |
| Affiliation: | 1. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan;3. Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan;4. Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan;5. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan;6. Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;7. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan;8. Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;9. NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan;10. Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan;11. Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan;12. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan |
| Abstract: | The association between kidney function and cancer incidence is inconsistent among previous reports, and data on the Japanese population are lacking. It is unknown whether kidney function modifies the cancer risk of other factors. We aimed to evaluate the association of estimated glomerular filtration rate (eGFR) with cancer incidence and mortality in 55 242 participants (median age, 57 years; 55% women) from the Japan Multi-Institutional Collaborative Cohort Study. We also investigated differences in cancer risk factors between individuals with and without kidney dysfunction. During a median 9.3-year follow-up period, 4278 (7.7%) subjects developed cancer. Moderately low and high eGFRs were associated with higher cancer incidence; compared with eGFR of 60-74 ml/min/1.73 m2, the adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for eGFRs of ≥90, 75-89, 45-59, 30-44 and 10-29 ml/min/1.73 m2 were 1.18 (1.07-1.29), 1.09 (1.01-1.17), 0.93 (0.83-1.04), 1.36 (1.00-1.84) and 1.12 (0.55-2.26), respectively. High eGFR was associated with higher cancer mortality, while low eGFR was not; the adjusted subdistribution HRs (95% CIs) for eGFRs of ≥90 and 75-89 ml/min/1.73 m2 were 1.58 (1.29-1.94) and 1.27 (1.08-1.50), respectively. Subgroup analyses of participants with eGFRs ≥60 and <60 ml/min/1.73 m2 revealed elevated cancer risks of smoking and family history of cancer in those with eGFR <60 ml/min/1.73 m2, with significant interactions. Our findings suggest that the relationship between eGFR and cancer incidence was U-shaped. Only high eGFR was associated with cancer mortality. Kidney dysfunction enhanced cancer risk from smoking. |
| Keywords: | CKD interaction J-MICC neoplasms onco-nephrology |