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CONFIRM Study: Correlation Between Analgesic Use and Risk of Renal Cell Carcinoma?

By: Vanessa A. Carter, BS
Posted: Friday, November 5, 2021

Roger L. Milne, PhD, of Cancer Council Victoria, Melbourne, Australia, and colleagues shared their findings from the Consortium for the Investigation of Renal Malignancies (CONFIRM) study regarding the influence of analgesic use on the risk of developing renal cell carcinoma. Published in Cancer Epidemiology, their results concluded that regular use of analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen in the United States) was associated with an increased risk, with the former increasing the risk in women alone.

A total of 1,064 eligible participants with incident renal cell carcinoma were recruited from the Queensland and Victorian Cancer Registries, and the control group (n = 724) was composed of partners or siblings of cases. A self-completed questionnaire that gathered data regarding the frequency and duration of analgesic use, health and lifestyle, and family history of cancer was administered. Models included each analgesic separately, NSAIDs combined (aspirin plus non-aspirin), and NSAIDs combined plus acetaminophen.

Most patients (76%) had clear cell renal cell carcinoma, followed by papillary (11%) and chromophobe tumors (9%). Users of NSAIDs combined included 22% of cases and 19% of controls; more women made up the NSAID combined users among cases, whereas more men made up this model among controls. Regular NSAID combined use correlated with a higher risk of renal cell carcinoma in women but not in men (odds ratio [OR] = 1.71 vs. 0.83).

Use of acetaminophen was also associated with a higher risk of renal cell carcinoma (OR = 1.12), although sex was not a determining factor. Additionally, hypertension appeared to be independently associated with risk among both NSAID combined users and acetaminophen users. When NSAID combined and acetaminophen were included together in the multivariable model, the estimated odds ratio remained similar. Of note, there was weak evidence for a dose response for duration of use of non-aspirin NSAIDs by women (P = .054) and no evidence for acetaminophen among both sexes (P = .77).

Disclosure: The study authors reported no conflicts of interest.

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