Sex differences in cancer outcomes across the range of eGFR

Shemilt, R. et al. (2024) Sex differences in cancer outcomes across the range of eGFR. Nephrology Dialysis Transplantation, (doi: 10.1093/ndt/gfae059) (PMID:38460949) (Early Online Publication)

Abstract

Background: People with chronic kidney disease (CKD) have increased incidence and mortality of most cancer types. We hypothesized that the odds of presenting with advanced cancer may vary according to differences in estimated glomerular filtration rate (eGFR), that this could contribute to increased all-cause mortality and that sex differences may exist. Methods: Data were from Secure Anonymised Information Linkage Databank, including people with de novo cancer diagnosis (2011–17) and two kidney function tests within 2 years prior to diagnosis to determine baseline eGFR (mL/min/1.73 m2). Logistic regression models determined the odds of presenting with advanced cancer by baseline eGFR. Cox proportional hazards models tested associations between baseline eGFRCr and all-cause mortality. Results: eGFR <30 was associated with higher odds of presenting with advanced cancer of prostate, breast and female genital organs, but not other cancer sites. Compared with eGFR >75–90, eGFR <30 was associated with greater hazards of all-cause mortality in both sexes, but the association was stronger in females [female: hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.56–1.88; male versus female comparison: HR 0.88, 95% CI 0.78–0.99]. Conclusions: Lower or higher eGFR was not associated with substantially higher odds of presenting with advanced cancer across most cancer sites, but was associated with reduced survival. A stronger association with all-cause mortality in females compared with males with eGFR <30 is concerning and warrants further scrutiny.

• Item Type: Articles
• Additional Information: This study was funded by a Chief Scientist Office (Scotland) Postdoctoral Lectureship awarded to J.S.L. (PCL/20/10) and a University of Sydney/University of Glasgow Office of Global Engagement Collaboration Partnership Award (9241562498). J.S.L. is funded by a Wellcome Trust Early Career Award (301005/Z/23/Z).
• Keywords: Cohort studies, *cancer, *chronic kidney disease.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Shemilt, Dr Richard and Jani, Dr Bhautesh and Mark, Professor Patrick and Sullivan, Dr Michael and Lees, Jennifer and McAllister, Professor David and Hanlon, Dr Peter and Elyan, Dr Benjamin

Creator Roles

Shemilt, R.: Conceptualization, Project administration, Writing – original draft, Writing – review and editing
Sullivan, M.: Conceptualization, Data curation, Funding acquisition, Investigation, Writing – review and editing
Hanlon, P.: Data curation, Writing – review and editing
Jani, B.: Data curation, Writing – review and editing
Elyan, B.: Writing – review and editing
McAllister, D.: Methodology, Writing – review and editing
Mark, P.: Conceptualization, Funding acquisition, Investigation, Supervision, Writing – review and editing
Lees, J.: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Investigation, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review and editing

• Authors: Shemilt, R., Sullivan, M.K., Hanlon, P., Jani, B., De La Mata, N., Rosales, B., Elyan, B.M.P., Hedley, J.A., Cutting, R.B., Wyld, M., McAllister, D.A., Webster, A.C., Mark, P.B., and Lees, J.S.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Nephrology Dialysis Transplantation
• Publisher: Oxford University Press
• ISSN: 0931-0509
• ISSN (Online): 1460-2385
• Published Online: 09 March 2024
• Copyright Holders: Copyright © The Author(s) 2024
• First Published: First published in Nephrology Dialysis Transplantation 2024
• Publisher Policy: Reproduced under a Creative Commons licence