Smoking is a risk factor in the clear cell and papillary subtypes of renal cell carcinoma (RCC), but not in chromophobe RCC, according to a study published in The Journal of Urology.

Neel Patel, MD, and fellow researchers from the Roswell Park Cancer Institute in Buffalo, NY, collected smoking data and retrospectively assessed 816 patients with nonfamilial RCC or benign pathology who had undergone nephrectomy at a National Comprehensive Cancer Network treatment center, seeking to find an association with histological diagnosis.

Among those patients, 21% were active smokers and 30% were former smokers.

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Active smoking was found to be more common among those with clear cell (23 percent) or papillary (26 percent) RCC compared to those with benign histology (14 percent each) or chromophobe RCC (6 percent).

Smoking history – both active and former – was generally found to be uncommon in chromophobe RCC (26 percent) compared to clear cell (53 percent) or papillary (58 percent). In addition, smoking extent based on mean pack-years was significantly lower in chromophobe RCC (9.4 mean pack-years) compared to clear cell (15.3 mean pack-years) or papillary (15.2 mean pack-years).

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Upon propensity analyses, both clear cell and papillary RCC were found to be independently associated with active smoking, but not chromophobe RCC.

“These findings underscore distinct carcinogenic mechanisms underlying the various RCC subtypes,” the authors concluded.


  1. Patel NH, Attwood KM, Hanzly M, et al. Comparative analysis of smoking as a risk factor among renal cell carcinoma histological subtypes. 2015. The Journal of Urology. [online ahead of print]. doi: 10.1016/j.juro.2015.03.125.