Epidemiology

Obesity, abdominal obesity and subsequent risk of kidney cancer: a cohort study of 23.3 million East Asians

Abstract

Background

Limited evidence exists regarding associations between obesity and kidney cancer among Asians. We examined the associations between obesity measures and risk of kidney cancer.

Methods

We included 23,313,046 adults who underwent health examinations provided by the Korean National Health Insurance Service 2009–2012 and performed multivariable Cox proportional hazards regression analyses.

Results

During 5.4 years of follow-up, 18,036 cases of kidney cancer were recorded, and cumulative incidence was 0.12%. General and abdominal obesity were associated with 1.32-fold increased risk of kidney cancer compared with groups without either obesity status. Underweight individuals showed decreased adjusted hazard ratio (HR) for kidney cancer (0.76, 95% confidence interval: 0.68–0.85) compared to those with normal body mass index (BMI), while the HRs increased among individuals with BMI 23–24.9 kg/m2 (1.23, 1.18–1.28), 25–29.9 kg/m2 (1.41, 1.36–1.46) and ≥30 kg/m2 (1.77, 1.65–1.90) (P for trend < 0.001). HRs of kidney cancer increased with increasing waist circumference (WC) (P for trend < 0.001). Compared to non-obese condition, the coexistence of general and abdominal obesity increased the HR (1.45, 1.40–1.50).

Conclusions

This study demonstrated positive associations of BMI and WC with kidney cancer risk. General and abdominal obesity may be risk factors of kidney cancer.

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Authors

Contributions

G.E.N., K.H.C. and Y.G.P. were the principal investigators. They contributed substantially to the study design, literature search, collection and assembly of data, data analyses and data interpretation. G.E.N., K.H.C. and Y.G.P wrote all drafts and the final version of the report. K.H. and Y.G.P. analysed data and created all the tables. G.E.N., K.H.C., K.H., C.M.K., B.H., S.J.C., S.J.J., Y.K., Y.H.K., D.H.K., S.M.K., Y.S.C., Y.K.R. and Y.G.P. contributed to the conception and design of the study, the collection and assembly of data, data analyses and data interpretation. All authors contributed to preparation of the report and approved the final version. K.H.C. and Y.G.P. had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis and all authors had final responsibility for the decision to submit for publication.

Corresponding authors

Correspondence to Kyung Hwan Cho or Yong Gyu Park.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study protocol was evaluated and approved by the Institutional Review Board of the Catholic University of Korea, St. Mary’s Hospital (IRB number: KC16EISI0939). This study was performed in accordance with the Declaration of Helsinki.

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None.

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Not applicable.

Data availability

Data are available through the Korean National Health Insurance Sharing Service (NHISS). Researchers who wish to access the data can apply at (https://nhiss.nhis.or.kr/bd/ay/bdaya001iv.do).

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Nam, G., Cho, K., Han, K. et al. Obesity, abdominal obesity and subsequent risk of kidney cancer: a cohort study of 23.3 million East Asians. Br J Cancer 121, 271–277 (2019). https://doi.org/10.1038/s41416-019-0500-z

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