The importance of reliable exposure estimates in deciding whether trichloroethylene can cause kidney cancer

Cherrie, John W.; Kromhout, Hans; Semple, Sean

doi:10.1007/s004320000206

Cited by 17 publications

(8 citation statements)

References 11 publications

(17 reference statements)

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“…All three of these studies reported strikingly elevated relative risks for renal cell cancer associated with TCE exposure. [167][168][169] The fi ndings contrast starkly with results from other investigations, and several serious methodological shortcomings of these studies have been noted, [170][171][172] limiting any conclusion that can be drawn. To date, seven occupational cohort studies have evaluated the relationship between TCE exposure and specifi c types of cancer.…”

Section: Occupationcontrasting

confidence: 87%

Epidemiologic characteristics and risk factors for renal cell cancer

McLaughlin¹

2009

CLEP

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Abstract:Incidence rates of renal cell cancer, which accounts for 85% of kidney cancers, have been rising in the United States and in most European countries for several decades. Family history is associated with a two-to four-fold increase in risk, but the major forms of inherited predisposition together account for less than 4% of renal cell cancers. Cigarette smoking, obesity, and hypertension are the most consistently established risk factors. Analgesics have not been convincingly linked with renal cell cancer risk. A reduced risk of renal cell cancer among statin users has been hypothesized but has not been adequately studied. A possible protective effect of fruit and vegetable consumption is the only moderately consistently reported dietary fi nding, and, with the exception of a positive association with parity, evidence for a role of hormonal or reproductive factors in the etiology of renal cell cancer in humans is limited. A recent hypothesis that moderate levels of alcohol consumption may be protective for renal cell cancer is not strongly supported by epidemiologic results, which are inconsistent with respect to the categories of alcohol consumption and the amount of alcohol intake reportedly associated with decreased risk. For occupational factors, the weight of the evidence does not provide consistent support for the hypotheses that renal cell cancer may be caused by asbestos, gasoline, or trichloroethylene exposure. The established determinants of renal cell cancer, cigarette smoking, obesity, and hypertension, account for less than half of these cancers. Novel epidemiologic approaches, including evaluation of gene-environment interactions and epigenetic mechanisms of inherited and acquired increased risk, are needed to explain the increasing incidence of renal cell cancer. Keywords: renal cell cancer, epidemiology, risk factor, review Descriptive epidemiologyKidney cancer is the ninth most common cancer in developed countries.1 Approximately 85% of kidney cancers are renal parenchyma (renal cell) cancers, while the remainder for the most part are urothelial cancers of the renal pelvis.2 Approximately 80% of renal cell cancers are clear cell adenocarcinomas, the remainder being papillary (∼15%), chromophobe (∼5%), and collecting duct carcinomas (Ͻ1%). Both renal cell and renal pelvis cancers are about twice as common among men as among women, [1][2][3] with the mean age at diagnosis in the early 60s for renal cell cancer and in the late 60s for renal pelvis cancer. For renal pelvis cancer, there is a strong tendency to develop multiple transitional epithelial tumors, particularly in the urinary bladder and ureter. 4 For the most part, renal pelvis cancer parallels bladder cancer in epidemiologic characteristics and risk factors and has been addressed by the authors elsewhere.

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Section: Occupationcontrasting

confidence: 87%

Epidemiologic characteristics and risk factors for renal cell cancer

McLaughlin¹

2009

CLEP

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“…European workers may have been more heavily exposed to TCE; however, the notion that European workers had higher levels of exposure is debatable. For example, in an assessment of potential differences in exposure levels between German studies of TCE and kidney cancer and US aerospace workers, researchers concluded that exposure levels were likely similar (Cherrie et al 2001). In addition, a comparison of regulatory standards in effect in Europe and the US indicates that US standards allowed for potentially higher exposures, and estimated comparisons of TCE exposures do not suggest that European workplaces had higher levels (Wong 2004).…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of occupational trichloroethylene exposure and liver cancer

Alexander

Kelsh

Mink

et al. 2007

Int Arch Occup Environ Health

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Although positive associations were observed for some analyses, results were inconsistent across occupational groups (aerospace/aircraft vs. other industries combined), study location, and incidence versus mortality endpoints. In addition, exposure-response trends were not observed consistently across studies. Interpretation is also limited by the potential impact of uncontrolled confounding by other occupational or lifestyle exposures such as smoking or alcohol consumption. Given these limitations, the currently available epidemiologic data are not sufficient to support a causal relation between occupational TCE exposure and liver/biliary cancer.

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“…The study resulted in an elevated OR of 10.8 (CI 3.4-34.8), which was highest among the risk estimates from corresponding studies reviewed by Wartenberg et al [2000]. Subsequently, this study was extensively debated [ Green and Lash, 1999;Vamvakas et al, 2000Vamvakas et al, , 2001aWartenberg et al, 2000;Cherrie et al, 2001;Mandel, 2001]. Specifically, questions on the selection of controls and shortcomings of the matching procedure were addressed.…”

Section: Renal Carcinogenicity Of Tri-contribution To the Status Quo mentioning

confidence: 99%