Dietary Acrylamide Intake and Risk of Renal Cell Carcinoma in Two Large Prospective Cohorts

Rebecca E. Graff; Eunyoung Cho; Mark A. Preston; Alejandro Sanchez; Lorelei A. Mucci; Kathryn M. Wilson

doi:10.1158/1055-9965.EPI-18-0320

DOI: 10.1158/1055-9965.EPI-18-0320 Published August 2018

Article Figures & Data

Tables

Table 1.

Age-adjusted characteristics of the study population at baseline (1980 for the NHS and 1986 for the HPFS) according to quartiles of energy-adjusted dietary acrylamide intake

		Baseline dietary acrylamide intake quartile (μg/day)
		Men (HPFS)				Women (NHS)
		Quartile 1	Quartile 2	Quartile 3	Quartile 4	Quartile 1	Quartile 2	Quartile 3	Quartile 4
	Range:	≤14.64	14.65–20.16	20.17–27.46	≥27.47	≤10.19	10.20–15.05	15.06–20.80	≥20.81
Characteristic	Median:	11.06	17.42	23.23	35.11	7.12	12.65	17.63	25.80
Number		12,484	12,027	11,774	11,512	22,593	22,147	22,041	21,986
Mean age, years (SD)^a		57.1 (9.7)	55.2 (9.7)	53.8 (9.5)	51.5 (9.2)	48.3 (7.1)	47.2 (7.2)	46.4 (7.1)	45.1 (6.9)
Mean BMI, kg/m² (SD)		25.4 (3.5)	25.5 (3.3)	25.5 (3.2)	25.7 (3.4)	24.6 (4.7)	24.4 (4.6)	24.3 (4.4)	24.3 (4.4)
Diagnosis of hypertension		24.4%	21.8%	20.8%	20.8%	19.7%	17.0%	14.8%	13.4%
Diabetes		3.1%	3.1%	3.3%	3.1%	3.1%	2.3%	2.1%	1.7%
Smoking status
Never		51.9%	48.7%	44.6%	41.7%	49.1%	47.2%	42.6%	35.6%
Past, quit >10 years before baseline		29.0%	30.2%	31.7%	30.5%	17.0%	17.1%	16.3%	13.8%
Past, quit ≤10 years before baseline		11.2%	12.0%	13.7%	14.7%	11.7%	10.9%	11.5%	11.1%
Current		7.9%	9.1%	10.1%	13.2%	22.2%	24.8%	29.6%	39.5%
Mean pack-years of smoking (SD)^b		23.9 (19.0)	24.9 (19.0)	25.5 (19.2)	27.9 (20.1)	19.0 (16.5)	19.2 (16.4)	20.5 (16.6)	23.0 (17.0)
Nulliparous		—	—	—	—	6.3%	5.9%	5.5%	5.7%
Mean parity, number of children (SD)^c		—	—	—	—	3.1 (1.5)	3.2 (1.5)	3.2 (1.5)	3.2 (1.5)
Mean (SD) nutrient & food intakes
Total calories, kcal/day		1,997 (641)	2,061 (615)	1,931 (569)	1,943 (640)	1,569 (509)	1,615 (504)	1,576 (473)	1,499 (513)
Alcohol, g/day		11.8 (17.2)	12.1 (16.0)	11.1 (14.2)	10.0 (13.6)	6.5 (11.4)	6.6 (11.0)	6.4 (10.1)	5.7 (9.3)
Breads, servings/day^d		1.6 (1.3)	2.0 (1.5)	2.1 (1.6)	2.1 (1.6)	1.3 (1.0)	1.5 (1.1)	1.7 (1.2)	1.7 (1.3)
Baked goods, servings/week^e		4.9 (6.6)	6.4 (7.8)	6.3 (7.5)	6.4 (7.5)	2.5 (3.2)	3.8 (4.8)	4.6 (6.1)	5.5 (7.4)
Cereal, servings/week		2.1 (2.5)	2.7 (2.8)	3.1 (3.1)	3.4 (4.6)	1.7 (2.4)	2.1 (2.6)	2.1 (2.8)	2.1 (3.2)
Potatoes, servings/week^f		2.7 (2.4)	3.4 (2.4)	3.8 (2.5)	5.5 (3.6)	2.3 (2.2)	3.0 (2.4)	3.4 (2.5)	4.8 (3.8)
Coffee, cups/day^g		1.0 (1.2)	1.7 (1.5)	2.3 (1.8)	2.8 (2.1)	0.8 (1.0)	1.8 (1.6)	2.7 (1.8)	3.6 (1.9)

NOTE: Percentages may not add up as expected due to rounding.
Abbreviation: BMI, body mass index.
↵^aNot adjusted for age.
↵^bAmong 24,396 male ever smokers and 49,822 female ever smokers.
↵^cAmong 82,158 parous women.
↵^dBreads include white bread, rye bread, other dark bread, English muffins/bagels/rolls, muffins/biscuits, pancakes/waffles, crackers, pizza, tortillas, pretzels, breakfast bars, energy bars, and high-protein bars.
↵^eBaked goods include cookies, cake, pie, brownies, doughnuts, and sweet rolls/coffee cake/other pastries.
↵^fPotatoes include baked/boiled/mashed potatoes, French fries, and potato chips.
↵^gCoffee includes regular, decaffeinated, and dairy coffee drinks.

Table 2.

HR and 95% CI for quartiles of energy-adjusted dietary acrylamide intake and risk of total RCC in the full cohorts and among never-smokers, and risk of fatal RCC and clear cell RCC in the full cohorts

	Men (HPFS)			Women (NHS)
	# Cases	Simple HR (95% CI)^a	Multivariable HR (95% CI)^b	# Cases	Simple HR (95% CI)^a	Multivariable HR (95% CI)^b
Total RCC
Full cohort
Quartile 1	66	1.00 (ref.)	1.00 (ref.)	82	1.00 (ref.)	1.00 (ref.)
Quartile 2	86	1.32 (0.95–1.82)	1.32 (0.95–1.84)	87	0.94 (0.69–1.27)	0.93 (0.69–1.27)
Quartile 3	68	1.04 (0.73–1.46)	1.01 (0.71–1.43)	96	1.02 (0.76–1.38)	1.01 (0.75–1.36)
Quartile 4	72	1.21 (0.86–1.70)	1.09 (0.77–1.55)	72	0.87 (0.63–1.19)	0.85 (0.61–1.17)
P_trend		0.54	0.96		0.47	0.39
Never-smokers
Quartile 1	25	1.00 (ref.)	1.00 (ref.)	39	1.00 (ref)	1.00 (ref.)
Quartile 2	30	1.16 (0.68–2.00)	1.24 (0.72–2.14)	42	1.01 (0.65–1.57)	1.00 (0.64–1.55)
Quartile 3	33	1.37 (0.80–2.34)	1.42 (0.83–2.44)	41	1.08 (0.69–1.68)	1.07 (0.68–1.67)
Quartile 4	34	1.63 (0.96–2.78)	1.59 (0.93–2.72)	29	1.06 (0.65–1.73)	1.05 (0.64–1.71)
P_trend		0.06	0.09		0.76	0.79
Fatal RCC
Full cohort
Quartile 1	16	1.00 (ref.)	1.00 (ref.)	24	1.00 (ref.)	1.00 (ref.)
Quartile 2	24	1.68 (0.89–3.19)	1.71 (0.90–3.25)	19	0.81 (0.44–1.49)	0.79 (0.43–1.45)
Quartile 3	20	1.51 (0.77–2.94)	1.48 (0.76–2.90)	21	0.93 (0.51–1.68)	0.89 (0.49–1.61)
Quartile 4	24	2.02 (1.06–3.85)	1.82 (0.94–3.52)	23	1.13 (0.63–2.02)	1.09 (0.60–1.97)
P_trend		0.05	0.13		0.59	0.68
Clear cell RCC
Full cohort
Quartile 1	38	1.00 (ref.)	1.00 (ref.)	58	1.00 (ref.)	1.00 (ref.)
Quartile 2	53	1.36 (0.89–2.07)	1.34 (0.87–2.04)	61	0.91 (0.64–1.31)	0.92 (0.64–1.33)
Quartile 3	42	1.04 (0.67–1.62)	0.98 (0.62–1.53)	59	0.88 (0.61–1.27)	0.88 (0.61–1.27)
Quartile 4	46	1.25 (0.81–1.94)	1.09 (0.70–1.70)	54	0.92 (0.63–1.34)	0.92 (0.63–1.35)
P_trend		0.56	0.91		0.66	0.67

↵^aStratified by age in months and calendar time.
↵^bAdditionally adjusted for BMI (<23, 23–<25, 25–<27, and ≥27 kg/m²), history of hypertension (yes and no), history of diabetes (yes and no), smoking status (analyses including smokers only; never, former/quit >10 years ago, former/quit ≤10 years ago, and current), pack-years (analyses including smokers only; continuous), duration of nonaspirin nonsteroidal anti-inflammatory drug use (<5 years and ≥5 years), energy intake (continuous), alcohol consumption (quartiles), and parity (NHS only; 0, 1–2, 3, and ≥4 children).