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Smoking and Renal Cell Carcinoma¹

Istituto di Ricerche Farmacologiche "Mario Negri," Via Eritrea 62, 20157 Milan, Italy [C. L., E. N., B. D.]; Institute of Social and Preventive Medicine, University of Lausanne, 1005 Lausanne, Switzerland [C. L.]; and Aviano Cancer Centre, 33081 Aviano, Pordenone, Italy [S. F.]

The relationship between smoking habits and the risk of renal cell carcinoma was investigated in a case-control study conducted in northern Italy on 131 cases of histologically confirmed cancers of the renal parenchyma (85 males, 46 females) and 394 controls in hospital for acute, nonneoplastic, nonurological disorders. Compared with never smokers, the relative risk (RR) was 1.7 (95% confidence interval = 1.0–3.1) among ex-smokers. A direct and significant dose-risk relationship was observed among current smokers, with RR of 1.1, 1.9, and 2.3 for moderate, intermediate, and heavy smokers. This trend in risk was statistically significant (x²₁ = 5.04; P = 0.02). The risk was directly related with duration of smoking (RR = 1.7 for <30 versus 1.8 for 30 years, P = 0.04), and inversely with age at starting (RR = 2.0 for 20 versus 1.7 for >20 years) and, among ex-smokers, with time elapsed since stopping (RR = 2.2 for <10 versus 1.3 for 10 years). This pattern of risk, together with the absence of appreciable confounding, adds further evidence for a causal nature of the association between smoking and renal cell cancer.

¹ This work was conducted within the framework of the National Research Council (CNR), Applied Projects "Oncology" (Contract 87.01544.44) and "Risk Factors for Disease," and with the contribution of Italian Association for Cancer Research and the Italian League against Tumors, Milan.

² To whom requests for reprints should be addressed, at "M. Negri" Institute for Pharmacological Research, Via Eritrea, 62, 20157 Milan, Italy.

Received 1/25/90. Revised 4/24/90.

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