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Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study



We examined the association between kidney stones and renal cell carcinoma (RCC) and upper tract urothelial carcinoma (UTUC) risk in the Netherlands Cohort Study on diet and cancer.


In total, 120,852 participants aged 55–69 completed a self-administered questionnaire on diet, medical conditions and other risk factors for cancer at baseline (1986). After 20.3 years of cancer follow-up 4352 subcohort members, 544 RCC cases and 140 UTUC cases were eligible for case-cohort analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated by multivariable-adjusted proportional hazards models.


Kidney stones were associated with an increased RCC risk (HR: 1.39, 95% CI 1.05–1.84), vs. no kidney stones. Kidney stones were associated with an increased risk of papillary RCC (HR: 3.08, 95% CI 1.55–6.11), but not clear-cell RCC (HR: 1.14, 95% CI 0.79–1.65). UTUC risk was increased for participants with kidney stones (HR: 1.66, 95% CI 1.03–2.68). No heterogeneity of associations was found for UTUC in the ureter and renal pelvis. An early kidney stone diagnosis (≤40 years) was associated with an increased RCC and UTUC risk, compared to later diagnosis.


Kidney stones were associated with increased papillary RCC risk, but not clear-cell RCC risk. No heterogeneity was found for UTUC subtypes.

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We are indebted to the participants of this study and wish to thank the Netherlands Cancer Registry (IKNL), and Netherlands Pathology Registry (PALGA). We are grateful to Dr. C. Hulsbergen-van de Kaa and Dr. M. Baldewijns for revising the tumour histology. We also thank the staff of the Netherlands Cohort Study for their valuable contributions. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

All authors participated in the analysis and interpretation of data; L.J.S. conceived the study. J.A.A.v.d.P. carried out the statistical analyses and drafted the manuscript. J.A.A.v.d.P. and L.J.S. interpreted the data. P.A.v.d.B. and L.J.S. critically revised the manuscript. P.A.v.d.B. is principle investigator of the Netherlands Cohort Study. All authors approved the final manuscript as submitted.

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The institutional review boards of the Netherlands Organization for Applied Scientific Research TNO (Zeist) and Maastricht University (Maastricht) approved the NLCS. The NLCS was conducted in accordance with the Declaration of Helsinki. By completing and returning the baseline questionnaire, participants agreed to participate in the NLCS.


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Correspondence to Jeroen A. A. van de Pol.

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