Nutrition and other risk factors for renal cell carcinoma in postmenopausal women

Among 35,192 postmenopausal, predominantly white women in Iowa age 55-69 years and free of cancer, we collected baseline history, dietary information, and anthropometric data by mail in 1986. We ascertained the 8-year incidence (62 new cases) of renal cell carcinoma using the Iowa Surveillance, Epidemiology, and End Results (SEER) register, the National Death Index, and mail follow-up. Risk factors for renal cell carcinoma included increasing age, increasing weight (either current, maximum adult weight, or weight at ages 18, 30, or 50 years), greater waist-to-hip ratio, and a history of blood transfusion. Total dietary calcium was associated independently with a reduced risk of renal cell carcinoma. No other dietary micro- or macronutrients or food groups were predictive of the development of renal cell carcinoma. Other previously identified risk factors were not confirmed: most notably, there was no increased risk from a history of hypertension, after adjustment for diuretic use. History of ever-use of diuretics was associated with a twofold increased risk of renal cancer, although the strength of association was markedly reduced after adjustment for age, weight, waist-to-hip ratio, and calcium intake.