Familial Risk of Renal Cell Cancer and Interaction with Obesity and Hyperglycemia: A Population-Based Study

Sung Won Lee, Hyun Jung Kim, Sayada Zartasha Kazmi, Yoon Jung Choi, Gahwi Hong, Young Shin Kim, Jungmin Eom, Heather Swan, Jaewoo Cha, Taeuk Kang, Hoo Jae Hann, Hyeong Sik Ahn

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2 Scopus citations


Purpose:We quantified the familial risk of renal cell cancer (RCC) among first-degree relatives (FDRs) on a population level, and examined interactions between family history and body mass index or blood glucose.Materials and Methods:Using the National Health Insurance database, which covers the entire Korean population, and the National Health Screening Program, we constructed a cohort of 5,524,403 individuals with blood-related FDRs and their lifestyle factors from 2002 to 2018. We calculated familial risk using incidence risk ratios (IRRs) with 95% confidence intervals, which compares the risk of individuals with and without FDR. The combined effect and interaction of a given risk factor and family history of RCC were measured by the relative excess risk due to interaction.Results:Individuals with affected FDRs showed a 2.29-fold (95% CI 1.68-3.13) increased risk of disease. Familial risk adjusted for lifestyle factors showed minimal attenuation (IRR 2.25; 95% CI: 1.65-3.08), suggesting that genetic predisposition is the main contributor in the familial aggregation of RCC. Individuals with both a positive family history and overweight/obesity (IRR 3.71, 95% CI 2.50-4.92) or hyperglycemia (IRR 4.52, 95% CI 2.59-6.45) had a significantly higher risk that exceeded the sum of their individual risks, suggesting an interaction that was statistically significant (relative excess risk due to interaction 95% CI: 0.91, -0.21-2.12; 2.21, 0.28-4.14).Conclusions:Our findings suggest an interaction between genetic and environmental factors, namely obesity and hyperglycemia. Individuals with both factors should be considered a high-risk group and advised to undergo genetic counseling.

Original languageEnglish
Pages (from-to)251-258
Number of pages8
JournalJournal of Urology
Issue number2
StatePublished - 1 Aug 2022

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Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.


  • carcinoma, renal cell
  • gene-environment interaction
  • hyperglycemia
  • obesity


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