IARC 60th Anniversary - 19-21 May 2026
Session : 21/05/26 - Posters
The future burden of renal cell carcinoma preventable by behavior modification in North America, Europe, and Australia.
MACINNIS R. 1,2, PICKETT C. 1, VAJDIC C. 3, WANG M. 4,5,6, MILNE R. 1,2,7, SINCLAIR C. 1, SMITH-WARNER S. 4,11, LAAKSONEN M. 8,9,10
1 Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia; 2 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; 3 Surveillance and Evaluation Research Program, The Kirby Institute, University of New South Wales, Sydney, Australia; 4 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States; 5 Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, United States; 6 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, United States; 7 Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia; 8 School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, Australia; 9 School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia; 10 Finnish Institute for Health and Welfare (THL), Helsinki, Finland; 11 Department of Nutrition, Harvard T.H. Chan School of Public Healt, Boston, United States
Background
Incidence of renal cell carcinoma has increased over the last 30 years worldwide. There is convincing evidence that people with excess body fat and those who have smoked cigarettes have an increased risk of renal cell carcinoma. Males are also twice as likely to develop the disease than females. Previous estimates of population attributable fractions (PAFs) for the burden of renal cell carcinoma attributable to these exposures may not reflect the decrease in the prevalence of smoking and the increase in the prevalence of overweight and obesity in industrialised countries over time.
Objectives
We aimed to quantify the burden of renal cell carcinoma that could be prevented by modifying current prevalence of exposure to these risk factors across 8 countries in North America, Europe, and Australia.
Methods
We analysed harmonised data from 23 cohort studies participating in the Pooling Project of Prospective Studies of Diet and Cancer (DCPP) (N = 2,253,519 participants) to estimate the sex-specific associations between body mass index and smoking status and renal cell carcinoma incidence using adjusted proportional hazards models. Study-specific hazard ratios for body mass index (overweight 25-29.9 and obesity ≥30 versus <25 kg/m2) and smoking (former and current versus never) were pooled and adjusted for age, alcohol consumption and height. We restricted analyses to up to the first 10 years of cohort follow-up to generate comparable estimates across studies. We estimated exposure prevalence from representative contemporaneous health surveys: Australian National Health Survey 2022, Canadian Health Measures Survey 2017-18, European Health Interview Survey 2015-19, and U.S. National Health and Nutrition Examination Survey 2017-20. We combined the study-specific hazard ratio and prevalence estimates to calculate country-specific PAFs with 95% confidence intervals (CIs), accounting for competing risk of death.
Results
During follow-up, 4,835 renal cell carcinomas were documented and 510,174 people died from any cause.
For males, current prevalence of overweight and obesity explained between 19% (Netherlands) and 32% (U.S.), current or past smoking explained between 10% (Sweden) and 18% (Germany), and these exposures jointly explained between 28% (Sweden) and 43% (U.S.) of the renal cell carcinoma burden.
For females, current prevalence of overweight and obesity explained between 20% (Denmark) and 35% (U.S.), current or past smoking explained between 8% (Sweden) and 15% (Germany), and these exposures jointly explained between 30% (Sweden) and 45% (U.S.) of the renal cell carcinoma burden.
Based on IARC Global Cancer Observatory: Cancer Tomorrow projections, the current prevalence of smoking and of overweight and obesity and their associated risks for renal cell carcinoma will translate into 35,802 male and 19,348 female incident renal cell cancer cases over the next 10 years for the countries assessed.
Conclusions/Implications
The high prevalence of overweight and obesity accounts for a considerable amount of the renal cell carcinoma burden in the included countries. Jointly, body fatness and ever smoking are responsible for between 28-45% of renal cell carcinomas. These estimates will aid policymakers to assess the impact of achievable behavioural changes to reduce cancer burden.