Association of chronic kidney disease with total and site-specific cancer incidence in participants of the Japan Public Health Center-based Prospective Study

Nephrol Dial Transplant. 2023 May 31;38(6):1487-1496. doi: 10.1093/ndt/gfac288.


Background: Although studies have found an association between chronic kidney disease (CKD) and cancer incidence, the results are inconsistent.

Methods: This study included participants in the Japan Public Health Center-based Prospective Study who had data on serum creatinine measurements. We assessed the association between estimated glomerular filtration rate (eGFR) and the risk of total and site-specific cancer incidence using a systematic survey in Japan. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for participant demographics and lifestyle factors.

Results: A total of 21 978 participants who met the inclusion criteria were followed up for a mean period of 12.9 years, during which a total of 2997 incident cancer cases were reported. In the multivariable adjusted models, an eGFR of <45 mL/min/1.73 m2 was not significantly associated with total cancer incidence (adjusted HR 1.22, 95% CI 0.94-1.60), compared with an eGFR of 60-89 mL/min/1.73 m2 (reference). The HR among those with eGFRs of ≥90 mL/min/1.73 m2 was 1.10 (95% CI 1.00-1.22).

Conclusions: In this large prospective study, a low eGFR was not significantly associated with an increased risk of total cancer incidence in patients with CKD, which may be partly due to an underpowered sample size. This finding may be due to the many shared risk factors between CKD and cancer.

Keywords: cancer; chronic kidney disease; diet factors; lifestyle factors, prospective cohort study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Japan / epidemiology
  • Neoplasms* / complications
  • Neoplasms* / etiology
  • Prospective Studies
  • Public Health
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / epidemiology
  • Risk Factors