Albuminuria, Kidney Function, and Cancer Risk in the Community.

TitleAlbuminuria, Kidney Function, and Cancer Risk in the Community.
Publication TypeJournal Article
Year of Publication2020
AuthorsMok Y, Ballew SH, Sang Y, Coresh JJ, Joshu CE, Platz EA
Secondary AuthorsMatsushita K
JournalAm J Epidemiol
Volume189
Issue9
Pagination942-950
Date Published2020 09 01
ISSN1476-6256
KeywordsAlbuminuria, Biomarkers, Tumor, Creatinine, Cystatin C, Female, Glomerular Filtration Rate, Humans, Incidence, Kidney Failure, Chronic, Male, Middle Aged, Neoplasms, Risk Factors, United States
Abstract

Few studies have comprehensively investigated the association of 2 key kidney disease measures, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR), with cancer incidence. In 8,935 participants at the baseline (1996-1998) from the Atherosclerosis Risk in Communities study, we quantified the associations of eGFR (based on creatinine and cystatin C) and ACR with cancer risk using Cox regression models adjusted for potential confounders. Due to changing guidelines for prostate cancer screening during the follow-up period, we investigated overall cancer, overall nonprostate cancer, and site-specific cancer. During a median follow-up of 14.7 years, 2,030 incident cancer cases occurred. In demographically adjusted models, low eGFR and high ACR were associated with cancer incidence (both overall and overall nonprostate cancer). These associations were attenuated after adjusting for other shared risk factors, with a significant association remaining only for ACR (≥103 compared with 5 mg/g) and overall nonprostate cancer. For site-specific cancer, only high ACR showed a significant association with lung and urinary tract cancers. Of these, the association between ACR and lung cancer appeared most robust in several sensitivity analyses. Kidney disease measures, particularly high ACR, were independently associated with cancer risk. The association between ACR and lung cancer was uniquely robust, warranting future studies to explore potential mechanisms.

DOI10.1093/aje/kwaa043
Alternate JournalAm J Epidemiol
PubMed ID32219380
PubMed Central IDPMC7443761
Grant ListP30 CA006973 / CA / NCI NIH HHS / United States
HHSN268201700002C / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700004C / HL / NHLBI NIH HHS / United States
U01 CA164975 / CA / NCI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005C / HL / NHLBI NIH HHS / United States
HHSN268201700001C / HL / NHLBI NIH HHS / United States
HHSN268201700003C / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States