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Type 2 diabetes and risk of renal cell carcinoma in two prospective cohorts
Alejandro Sanchez, M.D.1, Rebecca Graff, ScD2, Jed-Sian Cheng, MD, MPH3, Glen W. Barrisford, MD, MPH4, Dayron Rodriguez, MD, MPH1, Seth K. Bechis, MD, MS1, Michael L. Blute, MD1, Meir Stampfer, MD, DrPh5, Mark A. Preston, MD, MPH6, Kathryn M. Wilson, ScD7, Eunyoung Cho, ScD8.
1Department of Urology, Massachusetts General Hospital, Boston, MA, USA, 2Department of Epidemiology, Harvard T.H. Chan School of Public Health and Department of Epidemiology and Biostatistics, University of California, San Francisco, Boston, MA, USA, 3Department of Urology, Cooper University Hospital, Camden, NJ, USA, 4Department of Urology, Kaiser Permanente, Sant Rosa Medical Center, Santa Rosa, CA, USA, 5Department of Epidemiology, Harvard T.H. Chan School of Public Health and Channing Division of Network Medicine, Department of Medicine, Harvard T.H. Chan School of Public Health, MA, USA, 6Division of Urology, Brigham and Women's Hospital, Boston, MA, USA, 7Department of Epidemiology, Harvard T.H. Chan School of Public Health and Division of Network Medicine, Department of Medicine, Boston, MA, USA, 8Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital; Department of Dermatology and Epidemiology, Brown Univerisy, Providence, RI, USA.

Background: Studies of association between type 2 diabetes (T2D) and renal cell carcinoma (RCC) risk have yielded conflicting results. Methods: We utilized two prospective cohorts, 117,616 women from the Nurses’ Health Study (NHS) and 48,818 men from the Health Professionals Follow-up Study (HPFS) to evaluate the association between T2D and RCC. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 36 years of follow-up in the NHS we confirmed 357 RCC cases, including 106 fatal cases. During 26 years of follow-up in the HPFS we confirmed 228 RCC cases, including 48 fatal cases. Women with T2D had a significantly increased risk of RCC compared to women without T2D (adjusted HR 1.62; 95% CI 1.18-2.23). T2D was not associated with RCC among men (HR 0.94; 95% CI 0.56-1.59). There was a non-significant increased risk of fatal RCC among women (HR 1.48; 95% CI 0.76-2.86) and men (HR 1.34; 95% CI 0.46-4.05) with T2D. Among women, there was a suggestion that the association was stronger for ≤5 vs. >5 years duration of T2D (pdifference = 0.06). Conclusions: We found that T2D was associated with a significantly increased risk of total RCC in women, but not in men. T2D was suggestively associated with an increased risk of fatal RCC in both men and women.


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