Dietary Intakes of Trace Elements and the Risk of Kidney Cancer: The Singapore Chinese Health Study

Abstract

Background: Epidemiological studies have demonstrated separately that patients with kidney stone may have higher dietary intake of zinc and higher risk of developing kidney cancer. We prospectively assessed the associations of dietary zinc and other trace elements with kidney cancer risk for the first time.

Methods: We used data from the prospective Singapore Chinese Health Study that recruited 63,257 adult Chinese residing in Singapore between 1993 and 1998. A validated food frequency questionnaire and the Singapore Food Composition Database was used to compute the values of intake for zinc, copper and manganese. We identified incident cancer cases via linkage with nationwide cancer registry, and used Cox proportional hazard models to compute hazard ratio (HR) and 95% confidence interval (CI) for the association with kidney cancer risk.

Results: There were 229 incident kidney cancer cases after median follow-up of 20.1 years. Dietary zinc intake was positively associated with higher kidney cancer risk; the HR comparing the extreme quartiles of zinc intake was 1.74 (95% CI: 1.02-2.97; P-trend = 0.033). Conversely, intakes of copper and manganese were not associated with kidney cancer risk.

Conclusions: The positive association between dietary zinc and risk of kidney cancer suggests that zinc may be implicated in renal carcinogenesis.

Acknowledgments

We thank the Singapore Cancer Registry for the identification of cancer and mortality outcomes via database linkages. We also thank Siew-Hong Low of the National University of Singapore for supervising the fieldwork of the Singapore Chinese Health Study, and Renwei Wang for the maintenance of the cohort study database. In addition, we thank the founding principal investigator of the Singapore Chinese Health Study, Mimi C. Yu as well as all the cohort participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability

Data are available upon reasonable request from the corresponding author subject to approval by the IRB.

Author’s Contributions

WPK conceived the study, interpreted the data, and critically revised the reports. AZ analyzed the data. YW drafted and critically revised the reports. THJ critically revised the reports. JMY contributed to the acquisition of study materials and critically revised the reports. All authors revised and approved the final report.

Additional information

Funding

This work was supported by the National Institutes of Health, USA [RO1 CA144034 and UM1 CA182876]. W-P Koh is supported by the National Medical Research Council, Singapore (NMRC/CSA/0055/2013).