Department of Urology, University of Texas Health Science Center San Antonio, San Antonio, TX.
Department of Internal Medicine, Columbia University, New York, NY.
Urol Oncol. 2019 Jun;37(6):359-371. doi: 10.1016/j.urolonc.2018.12.008. Epub 2019 Jan 24.
To perform a systematic review of modifiable risk factors associated with the incidence of renal cell cancer (RCC). A systematic search of the literature was conducted using PubMed, Cochrane, and Web of Science databases from January 1996 until August 2017. We also extracted articles from the reference lists of identified studies and reviews. We targeted modifiable risk factors for RCC to include exercise, smoking, alcohol, diet, obesity, hypertension, and diabetes. We utilized predefined inclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. We identified a total of 464 relevant articles and excluded 209 via title and 130 after abstract review. We thoroughly reviewed a total of 125 manuscripts. Seven supplementary tables describe (a) case controls and (b) prospective cohort studies. We summarize the tables in figures to visualize the overall impact of these studies association (beneficial, harmful, or null) with RCC. Total physical activity if beneficial (10/12 studies), smoking is harmful (13/14 studies), alcohol was protective (i.e., beneficial, 13/16 studies), diet was indeterminate (13 beneficial, 13 harmful, and 9 nulls), obesity and hypertension were overwhelmingly harmful (36/36 studies and 17/18, respectively), and diabetes was detrimental (23/27 studies). Modifiable risk factors play an essential role in the development of RCC, and we should develop targeted RCC prevention strategies in at-risk individuals.
系统评价与肾细胞癌（RCC）发病相关的可改变风险因素。系统检索了 1996 年 1 月至 2017 年 8 月期间PubMed、Cochrane 和 Web of Science 数据库中的文献。我们还从确定的研究和综述的参考文献中提取了文章。我们将 RCC 的可改变风险因素确定为运动、吸烟、饮酒、饮食、肥胖、高血压和糖尿病。我们采用了预先确定的纳入标准和系统评价和荟萃分析报告的首选条目。我们共确定了 464 篇相关文章，通过标题排除了 209 篇，通过摘要排除了 130 篇。我们详细审查了总共 125 篇论文。7 个补充表格描述了（a）病例对照和（b）前瞻性队列研究。我们将表格汇总为图，以直观地展示这些研究与 RCC 的总体关联（有益、有害或无效）的影响。总体力活动有益（12 项研究中有 10 项），吸烟有害（14 项研究中有 13 项），饮酒有保护作用（即有益，16 项研究中有 13 项），饮食不确定（13 项有益，13 项有害，9 项无效），肥胖和高血压的危害极大（36 项研究和 17 项研究分别有 36 项和 18 项），糖尿病有害（27 项研究中有 23 项）。可改变的风险因素在 RCC 的发展中起着重要作用，我们应该在高危人群中制定有针对性的 RCC 预防策略。
