||5R01CA064158-02 Interpret this number
||Fred Hutchinson Cancer Research Center
||Diuretics and Renal Cell Cancer
DESCRIPTION: (Adapted from Applicant's Abstract). The reported incidence
of kidney cancer is increasing faster than almost any other malignancy in
the U.S. Approximately 29,000 new cases of RCC, the most common malignancy
involving the kidney, were recorded in the U.S. in 1993, with 12,000 deaths
resulting directly from the neoplasm. Apart from the association of RCC
with cigarette smoking, however, little is known about the aetiology of this
disease. Several case-control studies of RCC have shown an increased risk
among users of diuretics and non-diuretic antihypertensive medications.
Previously published studies, however, have not evaluated risk of RCC in
relation to dose and duration of drug use. Furthermore, previous studies
have not adequately disentangled the separate, and possibly interactive,
effects of hypertension and its treatment on risk of RCC. This proposed
population-based case-control study of members of Group Health Cooperative
(GHC) is designed to examine the hypothesis that antihypertensive therapy,
particularly diuretics, may increase risk of RCC. Specific parameters of
antihypertensive drug use to be examined include use (ever), formulation,
dosage and duration of use, time since first and last use, and indication
for use. Cases will consist of all individuals, age 18-85 years, with
primary RCC, diagnosed at GHC between January 1, 1981 and December 31, 1998.
A total of 435 RCC cases (290 men and 145 women) are expected to be
identified. Controls (1.5 per male case and 4 per female case) without a
history of kidney cancer will be randomly selected from computerized GHC
membership files and will be frequency matched to each case. Frequency
matching criteria will include year of birth (within 5 years), membership
status at reference date, GHC clinic attended and length of GHC enrollment.
GHC computerized pharmacy records will serve as the primary data source for
exposure to diuretics and other antihypertensive medications. Data
collection efforts will also include a review of outpatient medical records
for ascertaining information on potential confounders. Identifying a large
number of RCC cases and controls who can be well characterized with respect
to their prior drug exposures affords the opportunity to determine which, if
any, of hypertension, diuretic use, or non-diuretic antihypertensive drug
use is a risk factor for RCC. Clinical Increased clinical knowledge
regarding RCC, hypertension and its treatment may become apparent as a
result of this study. The relevance of the proposed investigation is
highlighted by the fact that at least 20% of Americans between the ages of
25-74 are on antihypertensive medications; hence, even a small alteration in
risk of RCC in relation to antihypertensive medication use could represent a
substantial impact on public health.
Hypertension, antihypertensive medication use, and risk of renal cell carcinoma.
, Williams M.A.
, Weiss N.S.
, Stergachis A.
, LaCroix A.Z.
, Barlow W.E.
American journal of epidemiology, 1999-03-15; 149(6), p. 521-30.
Body mass index and risk of renal cell carcinoma.
, Williams M.A.
, Weiss N.S.
Epidemiology (Cambridge, Mass.), 1999 Mar; 10(2), p. 188-91.