Epidemiological risk factors for adrenocortical carcinoma: A hospital‐based case–control study

Abstract

Adrenocortical carcinoma (ACC) is a rare malignancy whose risk factors are unclear. We explored the association of ACC risk with exposure to selected environmental factors, with a focus on cigarette smoking. We conducted a hospital‐based case–control study at The University of Texas MD Anderson Cancer Center. Cases (n = 432) patients with ACC treated at MD Anderson, and controls (n = 1,204) were healthy and genetically unrelated spouses of patients at MD Anderson who had cancers not associated with smoking. Information on the subjects’ demographic features and selected risk factors was collected using a structured, validated questionnaire and medical records review. Unconditional logistic regression was used to calculate adjusted odds ratios (AORs) via the maximum‐likelihood method. Cases had a younger mean (± standard deviation) age than did controls (47.0 ± 0.7 and 60.0 ± 0.3 years, respectively), and the majority of cases were female (60.6%) and non‐Hispanic white (82.4%). We found a markedly increased risk of ACC among male cigarette smokers, with an AOR = 1.8 (95% confidence interval [CI] =1.2–2.9), but not among female smokers (AOR = 1.1, 95% CI = 0.7–1.6). Family history of cancer was associated with increased risk of ACC (AOR = 2.8, 95% CI 1.9–4.3) and in both men and women, whereas alcohol consumption was associated with reduced risk in men (AOR = 0.2, 95% CI = 0.1–0.3) but not women (AOR = 0.7, 95% CI = 0.5–1.1). Understanding these risk factors and their underlying mechanisms may help prevent ACC in susceptible individuals and eventually identify new therapeutic options for ACC.

Adrenocortical carcinoma: current state of the art, ongoing controversies, and future directions in diagnosis and treatment

“… 11 , 16 Epidemiological risk factors for ACC are not well understood, although recent studies have identified an increased incidence in male cigarette smokers. 17 – 19 In females, estrogen exposure has been implicated as a risk factor due to an increased incidence of ACC in users of the oral contraceptive pill, 19 and the anti-proliferative effects of estrogen inhibition on ACC cells in vitro . 20 …”

PDL1 expression is associated with longer postoperative, survival in adrenocortical carcinoma

“…Adrenocortical carcinomas (ACCs) are rare cancers with 0.5-2 new cases per million diagnosed every year in the United States. 1,2 ACC is associated with a very poor prognosis. Complete surgical resection is the only curative therapeutic option but is possible in less than half of patients.…”

Trends in the incidence of adrenocortical carcinoma and pheochromocytoma/paraganglioma in Taiwan

“…In men, several studies ascertained that tobacco use increased the risk of adrenocortical carcinoma. [27][28][29][30] In women, increased risks were found in users of oral contraceptives, particularly those who used them before the age of 25 years. [27] Based on the results of trend analyses in our study, both sexes showed a similar upward trend in adrenocortical carcinoma incidence.…”