1
|
Brooks ER, Siriruchatanon M, Prabhu V, Charytan DM, Huang WC, Chen Y, Kang SK. Chronic kidney disease and risk of kidney or urothelial malignancy: systematic review and meta-analysis. Nephrol Dial Transplant 2024; 39:1023-1033. [PMID: 38037426 PMCID: PMC11139511 DOI: 10.1093/ndt/gfad249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is highly prevalent, affecting approximately 11% of US adults. Multiple studies have evaluated a potential association between CKD and urinary tract malignancies. Summary estimates of urinary tract malignancy risk in CKD patients with and without common co-existing conditions may guide clinical practice recommendations. METHODS Four electronic databases were searched for original cohort studies evaluating the association between CKD and urinary tract cancers (kidney cancer and urothelial carcinoma) through 25 May 2023, in persons with at least moderate CKD and no dialysis or kidney transplantation. Quality assessment was performed for studies meeting inclusion criteria using the Newcastle-Ottawa Scale. Meta-analysis with a random-effects model was performed for unadjusted incidence rate ratios (IRR) as well as adjusted hazard ratios (aHR) for confounding conditions (diabetes, hypertension and/or tobacco use), shown to have association with kidney cancer and urothelial carcinoma. Sub-analysis was conducted for estimates associated with CKD stages separately. RESULTS Six cohort studies with 8 617 563 persons were included. Overall, the methodological quality of the studies was good. CKD was associated with both higher unadjusted incidence and adjusted hazard of kidney cancer (IRR 3.36, 95% confidence interval (CI) 2.32-4.88; aHR 2.04, 95% CI 1.77-2.36) and urothelial cancer (IRR 3.96, 95% CI 2.44-6.40; aHR 1.35, 95% CI 1.22-1.50) compared with persons without CKD. Examining incident urinary tract cancers by CKD severity, risks were elevated in stage 3 CKD (kidney aHR 1.89, 95% CI 1.56-2.30; urothelial carcinoma aHR 1.35, 95% CI 1.20-1.52) as well as in stages 4/5 CKD (kidney cancer aHR 2.30, 95% CI 2.00-2.66; urothelial carcinoma aHR 1.24, 95% CI 1.04-1.49). CONCLUSIONS Even moderate CKD is associated with elevated risk of kidney cancer and urothelial carcinoma. Providers should consider these elevated risks when managing individuals with CKD, particularly when considering evaluation for the presence and etiology of hematuria.
Collapse
Affiliation(s)
- Emily R Brooks
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Vinay Prabhu
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - David M Charytan
- Department of Medicine, Division of Nephrology, NYU Grossman School of Medicine, New York, NY, USA
| | - William C Huang
- Department of Urology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yu Chen
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Stella K Kang
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
2
|
Xie Y, Shi K, Yuan Y, Gu M, Zhang S, Wang K, Fu L, Shen C, Yuan Z. Bibliometric Analysis Reveals the Progress of PM 2.5 in Health Research, Especially in Cancer Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1271. [PMID: 36674029 PMCID: PMC9859174 DOI: 10.3390/ijerph20021271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
PM2.5 has an aerodynamic diameter of less than or equal to 2.5 microns due to its inherent physical and chemical properties so that it can enter the alveoli through the respiratory tract for blood gas exchange. Numerous studies have shown that PM2.5 is a serious air pollutant that poses a wide range of health risks, especially for cancer. Bibliometric methods were employed to have comprehensively analyzed the research of PM2.5 in cancer for about a decade in Web of Science to identify hotspots and trends using VOSviewer, CiteSpace, and R. The field has undergone overall growth in the past decade. As research on PM2.5 in health deepens, cancer related to it expanded beyond the respiratory system to the digestive system, urinary system, female gonadal axis, breast cancer and other cancers. Another observation is that research on PM2.5 in cancer has progressed in the mechanisms of deterioration, such as the role of matrix metalloproteinases in cancer. In addition, research on the risks of PM2.5 in combination with polycyclic aromatic hydrocarbons and heavy metals has also emerged. Results showed that there are relatively more studies on PM2.5 in high-latitude countries, which may be due to different national conditions, such as climate and coal combustion. Our research has combed through the progress of PM2.5 in cancer research and provided a supplement for developing pollution prevention ideas with different national conditions in this field.
Collapse
Affiliation(s)
- Yaxuan Xie
- School of Public Health, Wuhan University, Wuhan 430000, China
| | - Kejian Shi
- School of Public Health, Wuhan University, Wuhan 430000, China
| | - Yuncong Yuan
- College of Life Sciences, Wuhan University, Wuhan 430000, China
| | - Meijia Gu
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan 430000, China
| | - Shihan Zhang
- School of Public Health, Wuhan University, Wuhan 430000, China
| | - Kai Wang
- School of Public Health, Wuhan University, Wuhan 430000, China
| | - Liangying Fu
- School of Public Health, Wuhan University, Wuhan 430000, China
| | - Chao Shen
- College of Life Sciences, Wuhan University, Wuhan 430000, China
| | - Zhanpeng Yuan
- School of Public Health, Wuhan University, Wuhan 430000, China
- Hubei Provincial Key Laboratory of Applied Toxicology, D1 Safety Assessment Center, Bio-City Innovation Park, Wuhan 430000, China
| |
Collapse
|
3
|
Chan TC, Chuang YH, Hu TH, Y.-H. Lin H, Hwang JS. Mortality risk and years of life lost for people with reduced renal function detected from regular health checkup: A matched cohort study. Prev Med Rep 2023; 31:102107. [PMID: 36820368 PMCID: PMC9938332 DOI: 10.1016/j.pmedr.2022.102107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/06/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023] Open
Abstract
With the increasing threat of metabolic syndromes, a focus on maintaining kidney health from early- to mid-adulthood is necessary. This study elucidates mortality risk and years of life lost (YLLs) due to abnormal renal function. This was a retrospective, matched cohort study from health checkup data from 2000 to 2015. We identified 12,774 participants with abnormal renal function (eGFR < 60 mL/min/1.73 m2) and used propensity score matching to identify 25,548 participants with normal renal function (eGFR ≥ 60). YLLs were estimated using the life expectancy differences between the abnormal and matched normal cohorts. Cox models were used to estimate the adjusted mortality risk. The estimated life expectancy of participants with proteinuria and eGFR < 60 was 26.24 years, with a 95 % confidence interval of (23.96, 29.36), 17.62 (16.37, 18.78), and 11.70 (11.02, 12.46) for age groups of 30 - 54, 55 - 64, and 65 - 79 years, respectively. The estimated YLLs of participants with proteinuria and eGFR < 60, as compared with the matched normal cohort, were 17.86 (13.41, 20.36), 12.55 (11.41, 13.78), and 8.31 (7.47, 9.13) years for the three age groups, respectively. The Cox model estimates of mortality hazard ratios of participants having proteinuria and eGFR < 60 against matched referents were 5.29 (3.97, 7.05), 3.99 (3.34, 4.75), and 3.05 (2.62, 3.55) for the three age groups, respectively. Abnormal renal function shortens life expectancy, particularly in patients with proteinuria and in younger adults. Active health management of renal function can reduce the disease burden.
Collapse
Key Words
- AFP, Alpha-fetoprotein
- CI, Confidence Interval
- CKD, Chronic Kidney Disease
- COD, Cause of Death
- CVD, Cardiovascular Disease
- DM, Diabetes Mellitus
- ESRD, End-stage Renal Disease
- HR, Hazard Ratio
- HTN, Hypertension
- Hazard of death
- Health check-up
- LE, Life Expectancy
- Life expectancy
- PS, Propensity Score
- Proteinuria
- RAS, Renin-angiotensin System
- SLED, Standardized Life Expectancy Deviation
- SMD, Standardized Mean Difference
- TCR, Taiwan Cancer Registry
- YLL, Years of Life Lost
- eGFR
- eGFR, estimated Glomerular Filtration Rate
Collapse
Affiliation(s)
- Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan,Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Corresponding authors.
| | - Yung-Hsin Chuang
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Tsuey-Hwa Hu
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Hugo Y.-H. Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan,Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Shiang Hwang
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan,Corresponding authors.
| |
Collapse
|
4
|
Huang YJ, Lee PH, Chen LC, Lin BC, Lin C, Chan TC. Relationships among green space, ambient fine particulate matter, and cancer incidence in Taiwan: A 16-year retrospective cohort study. ENVIRONMENTAL RESEARCH 2022; 212:113416. [PMID: 35523280 DOI: 10.1016/j.envres.2022.113416] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/27/2022] [Accepted: 04/30/2022] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Green space and air pollution have been recognized as vital health determinants. There is a paucity of studies examining the interplay between green space, fine particulate matter (PM2.5), and the incidence of specific cancers. OBJECTIVE We aimed to explore the contributions of green space and ambient PM2.5 to the risk of specific cancers in terms of the most common cancers based on incidence or mortality rate in Taiwan and to ascertain the interaction between green space and PM2.5 and their role in cancer risk. MATERIALS AND METHODS This retrospective longitudinal cohort study included 407,415 participants. Data were obtained from the 2000-2015 Mei Jau Health Examination Database linked to the Taiwan Cancer Registry and Causes of Death datasets. All participants were aged ≥20 years and had no history of cancer. The environmental exposure were the normalized difference vegetation index (NDVI) and the 2-year average PM2.5 at baseline. Multivariate adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models. We adjusted for covariates including demographics, anthropometrics, comorbidities, health behaviors, biochemical data, and environmental factors. RESULTS During a median follow-up of 10.37 years, 11,576 cancer cases were reported. PM2.5 exposure increased the risk of all cancers (HR: 1.11, [95% CI: 1.06-1.15]), stomach cancer (HR: 1.27, [1.02-1.58]), endocrine gland cancer (HR: 2.13, [1.39-3.26]), breast cancer (HR: 1.12, [1.03-1.22]), and lung cancer (HR: 1.12, [1.01-1.24]). An increase in NDVI reduced the risk of prostate cancer (HR: 0.93, [0.88-0.99]) and lung cancer (HR: 0.95, [0.91-0.99]). NDVI influenced the incidence of prostate and all cancers by reducing PM2.5 concentrations. CONCLUSION Long-term PM2.5 exposure is associated with an increased risk of some types of cancers. In contrast, an increase in environmental green space exposure is associated with lowering of the risk of prostate and lung cancer.
Collapse
Affiliation(s)
- Ying-Jhen Huang
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Ping-Hsien Lee
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Li-Chi Chen
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Bo-Cheng Lin
- Department of Real Estate and Built Environment, National Taipei University, New Taipei City, Taiwan
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
5
|
Ambient Cumulative PM2.5 Exposure and the Risk of Lung Cancer Incidence and Mortality: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312400. [PMID: 34886127 PMCID: PMC8656990 DOI: 10.3390/ijerph182312400] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/07/2023]
Abstract
Smoking, sex, air pollution, lifestyle, and diet may act independently or in concert with each other to contribute to the different outcomes of lung cancer (LC). This study aims to explore their associations with the carcinogenesis of LC, which will be useful for formulating further preventive strategies. This retrospective, longitudinal follow-up cohort study was carried out by connecting to the MJ Health Database, Taiwan Cancer Registry database, and Taiwan cause of death database from 2000 to 2015. The studied subjects were persons attending the health check-ups, distributed throughout the main island of Taiwan. Cox proportional hazards regression models were used to investigate the risk factors associated with LC development and mortality after stratifying by smoking status, with a special emphasis on ambient two-year average PM2.5 exposure, using a satellite-based spatiotemporal model at a resolution of 1 km2, and on dietary habit including consumption of fruits and vegetables. After a median follow-up of 12.3 years, 736 people developed LC, and 401 people died of LC-related causes. For never smokers, the risk of developing LC (aHR: 1.32, 95%CI: 1.12–1.56) and dying from LC-related causes (aHR: 1.28, 95%CI: 1.01–1.63) rises significantly with every 10 μg/m3 increment of PM2.5 exposure, but not for ever smokers. Daily consumption of more than two servings of vegetables and fruits is associated with lowering LC risk in ever smokers (aHR: 0.68, 95%CI: 0.47–0.97), and preventing PM2.5 exposure is associated with lowering LC risk for never smokers.
Collapse
|