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The association between analgesic use and risk of renal cancer

Principal Investigator
Name
Sara Karami
Institution
NCI, DCEG, OEEB
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
2011-0287
Initial CDAS Request Approval
Feb 2, 2012
Title
The association between analgesic use and risk of renal cancer
Summary
Malignant tumors of the kidney account for approximately 4% of cancer diagnoses and 2% of cancer deaths in the United States (U.S.) [1]. Renal cell carcinoma (RCC) of the renal parenchyma accounts for over 80% of all kidney cancers [2]. Since the 1950s, the incidence of RCC has increased by over 126% [3]. Major etiologic risk factors that are thought to explain approximately 50% of cases include obesity (high body mass index or BMI), hypertension, and smoking [2]. Other risk factors, such as use of analgesics have not been well-established. Certain analgesics like non-steroid anti-inflammatory drugs (NSAIDs) have been shown to inhibit renal prostaglandin synthesis which can lead to chronic subacute renal injury [4-6]. This type of injury increases the potential for DNA damage and thus the likelihood of carcinogenesis [7]. On the other hand, studies have also suggested that analgesics may protect against cancer by reducing inflammation [8-10]. Only a handful of epidemiological studies have evaluated renal cancer risk in relation to analgesic use; findings from these studies have been inconsistent [8-15]. To better understand the relationship between use of analgesics and renal cancer risk, we propose to conduct a pooled analysis across two cohort studies (PLCO and the NIH-AARP Diet and Health Study (NIH-AARP)).
Aims

§ The primary aim of this proposal includes: (1) Assessing the association between use of analgesics (i.e., NSAIDs, aspirin, ibuprofen, and acetaminophen) and RCC risk. We hypothesize that among regular users of analgesics there is an increased risk of RCC compared to non-regular users of analgesics. In PLCO, data regarding the frequency and regular use of ibuprofen- and aspirin- containing products was collected. § The secondary aims of this proposal include: (1) Assessing if certain risk factors (i.e., hypertension, sex, smoking, arthritis, osteoporosis or BMI) modify the association between analgesic use and RCC risk. (2) Assessing the association between analgesic use (i.e., NSAIDs, aspirin, ibuprofen, and acetaminophen) and the most common histologic subtype of RCC, clear cell RCC (ccRCC). (3) Assessing if use of analgesics (i.e., NSAIDs, aspirin, ibuprofen, and acetaminophen) is associated with cancer of the renal pelvis. (4) Assessing the association between use of analgesics and RCC risk among respondents of the PLCO supplemental risk factor (SQX) questionnaire.

Collaborators

Sarah Daugherty (DCEG, OEEB)
Mark Purdue (DCEG, OEEB)