Online Program

Nature versus nurture: A case for renal cell carcinoma

Monday, November 4, 2013

Benjamin Joseph Becerra, DrPH, MBA, MPH, MS, School of Allied Health Professions, Loma Linda University, Loma Linda, CA
Monideepa Becerra, DrPH, MPH, CHES, School of Public Health, Loma Linda University, Loma Linda, CA
Background: Renal cell carcinoma (RCC) is the most lethal of all genitourinary cancers and accounts for over 80% of all kidney cancers. Understanding the determinants of RCC is critical.

Method: A query was run using PubMed with the following words: renal cancer carcinoma OR hypernephroma AND risk factors. The search was limited to peer-reviewed articles in English from 1990 through 2012. Studies that did not exclusively analyze RCC-associated risk factors were excluded.

Results: The literature demonstrated two groups of risk factors: exogenous and endogenous. Exogenous factors included cigarette smoking where nearly 30% of all RCC have been attributable to that of tobacco use. Obesity was highlighted as a risk factor with majority of studies elucidating the role of obesity-induced release of Insulin-like Growth Factor-1. Other exogenous factors include hypertension and history of urinary tract infection, both shown to increase the odds of RCC. Various endogenous factors, such as Von Hippel Lindau and Birt-Hogg-Dubé Syndrome, were also identified.

Conclusion: In individuals predisposed to RCC due to genetics, presence of exogenous risk factors, such as smoking or obesity, can further increase their risk of RCC. Given that no more than 3% of all cancers are attributed to that of kidney cancers, there is comparatively less emphasis and research on RCC as compared to other types. This lack of research, especially those evaluating the role of gene-environment interactions, has been severely underplayed in case of RCC.

Learning Areas:

Public health biology

Learning Objectives:
Identify four major exogenous risk factors associated with renal cell carcinoma. List three major endogenous risk factors of renal cell carcinoma. Describe the current evidence on gene-environment interaction associated with renal cell carcinoma.

Keyword(s): Cancer, Risk Factors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I currently hold a masters in the biological sciences in addition to a MPH in Biostatistics. I'm currently a DrPH student in epidemiology and have conducted several independent research projects in the aforementioned fields in addition to supervising other students. My background in biological sciences research and epidemiology makes me qualified to assess the current literature in order to provide a systematic review of the current epidemiology of renal cell carcinoma.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.