Incidence of obesity and renal cell carcinoma (RCC) are increasing, and RCC remains a lethal disease if not identified at an early stage. There is an increasing body of evidence linking obesity to the risk of developing RCC.
There is a wealth of epidemiological evidence supporting a higher risk of developing RCC in obese individuals, and in a dose–response manner. This is particularly pertinent in the development of the clear cell subtype (ccRCC), in which there appears to be a special interplay between ccRCC, obesity and von Hippel-Lindau (VHL) gene defects, driving the proangiogenic/proliferative pathway as a result of metabolites produced by adipose tissue, the epigenetic silencing of a tumour suppressor in close proximity to the VHL gene, hypoxia, obesity-related hypertension, lipid peroxidation and increased insulin-like growth factor-1.
Obesity-related diseases, including cancers, are increasing. There are many complex biomolecular pathways interacting in obesity, especially in ccRCC in which there appears to be a specific interplay in VHL mutations.
The Mater Misericordiae University Hospital, Dublin, Ireland
Correspondence to Professor John M. Fitzpatrick, Professor and Chairman, Department of Surgery, Consultant Urological Surgeon, MCh FRCSI FC Urol (SA) FRCSGlas FRCS, The Mater Misericordiae Hospital, 47 Eccles St, Dublin 7, IrelandTel: +353 1 8308530; fax: +353 1 8300345; e-mail: firstname.lastname@example.org