title: Analgesic use and risk of renal cell carcinoma: A case-control, cohort and meta-analytic assessment.
abstract: Analgesics are the most commonly consumed drugs worldwide. Evidence that analgesics increase kidney cancer risk has been mixed. We investigated the association between renal cell carcinoma (RCC) and analgesic use in a large population-based case-control study and a post-trial observational cohort study. Findings were used to update a recent meta-analytic review. We analyzed data from 1,217 RCC cases and 1,235 controls in the US Kidney Cancer Study and 98,807 participants in the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO: n = 137 RCCs). Self-reported acetaminophen, aspirin and nonsteroid anti-inflammatory drug (NSAID) use and duration information was assessed in relation to RCC. For the US Kidney Cancer Study, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression. For PLCO, we computed hazard ratios (HRs) and 95%CIs using Cox regression. Among case-control participants, RCC risk was associated with over-the-counter acetaminophen use (OR = 1.35, 95%CI = 1.01-1.83). There was a positive trend with increasing duration (p-trend = 0.01), with a two-fold risk for use ≥10 years (OR = 2.01, 95%CI = 1.30-3.12). No association with prescription acetaminophen use was detected. In PLCO, acetaminophen use was also associated with increased RCC risk (HR = 1.68, 95%CI = 1.19-2.39), although elevated risk was absent among the few long-term users. No association with RCC risk was detected for aspirin or NSAIDs use in either study. An association between acetaminophen use and kidney cancer was supported by meta-analytic cohort (n = 4; summary relative risk = 1.34; 95%CI = 1.13-1.59; p-heterogeneity  = 0.40) and case-control (n = 9, summary OR = 1.20; 95%CI = 1.01-1.42; p-heterogeneity  = 0.05) findings. In brief, acetaminophen use may increase the risk of developing RCC.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Sara
authors.initials: S
authors.lastname: Karami
authors.affiliation: Patient-Centered Outcome Research Institute, Washington, DC.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Daughtery
authors.affiliation: Wayne State University, Karmanos Cancer Institute, Detroit, MI, 48201.|Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD.
authors.forename: Kendra
authors.initials: K
authors.lastname: Schwartz
authors.affiliation: University of Illinois, Chicago, IL, 60612.
authors.forename: Faith G
authors.initials: FG
authors.lastname: Davis
authors.affiliation: Wayne State University, Karmanos Cancer Institute, Detroit, MI, 48201.|Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD.
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Ruterbusch
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Sonja I
authors.initials: SI
authors.lastname: Berndt
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Hofmann
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Lee E
authors.initials: LE
authors.lastname: Moore
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, 20850.
authors.forename: Joanne S
authors.initials: JS
authors.lastname: Colt
mesh_terms: D000700:Analgesics / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002292:Carcinoma, Renal Cell / Q000453:epidemiology* / Q000209:etiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D016017:Odds Ratio; D012306:Risk; D014481:United States / Q000453:epidemiology
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: acetaminophen; analgesics; kidney cancer; meta-analysis; renal cell carcinoma