medwireNews: Diabetes has a stronger association with the risk for kidney cancer in women than men, despite men being overall more likely to develop the malignancy, shows a nationwide cohort study from Korea.
Jay Shen (University of Nevada, Las Vegas, USA) and colleagues looked at data from more than 5 million men and 4 million women who took part in the South Korean national health screening program in 2009. None of these people had a history of cancer or were diagnosed with it within 1 year of baseline, but during follow-up to the end of 2018, there were 12,381 cases of kidney cancer in this population.
The incidence rate was higher in men than women, irrespective of smoking status. For example, in never smokers the rates of kidney cancer per 100,000 person–years were 17.8 and 8.5 in men and women with normoglycemia, respectively, and the corresponding rates in those with diabetes were 38.2 and 19.0.
In both sexes, impaired glucose metabolism (based on fasting plasma glucose) was associated with higher rates of kidney cancer. However, after adjusting for factors such as age, alcohol consumption, and BMI, the effect was more prominent in women than men.
Specifically, in never smokers, women with prediabetes had a significant 19% increased risk for kidney cancer and those with diabetes had a 34% increased risk, whereas the corresponding risk increases in men were a nonsignificant 6% and a significant 25%.
The findings were similar in ever smokers, although the relative risk increase associated with impaired glucose metabolism was somewhat larger. Compared with never smokers with normoglycemia, the risk increases associated with prediabetes and diabetes in women who had ever smoked were 56% and 85%, respectively, and in men they were 22% and 49%.
This was despite the absolute incidence rates of kidney cancer being no higher in ever smokers than never smokers, although the adjusted risk was slightly higher in male ever smokers, by 12%.
“Although kidney cancer is predominant in men, women with prediabetes are at an increased risk of kidney cancer,” write the researchers in Diabetes Care.
“This finding should not be overlooked during the monitoring of individuals with hyperglycemia for kidney complications.”
And they add that “given the increasing incidence of kidney cancer, particularly in the younger population, adequate management of diabetes and prediabetes may help to reduce the risk of developing kidney cancer.”
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Diabetes Care 2022; doi:10.2337/dc22-0961