World Kidney Cancer Day 2022: How Bad Is Smoking For Your Kidneys? Smoking & Risk Of Kidney Cancer

Smoking is a well-known risk factor for many diseases and kidney diseases are no exception. Recent studies have proven that smoking plays an important role in renal diseases. Smoking is one of the risk factors not only for the development of kidney disease but also for the progression and worsening of pre-existing kidney diseases. 

Cigarette smoking has been found to be associated with cancers of the kidney and urinary tract. It is estimated that cigarette smoking is responsible for approximately 17.4% of kidney, renal pelvis, and ureter cancer cases in the United States. Prevalence of kidney cancers is more in men than in women.

The most common kidney cancer associated with smoking is Renal cell carcinoma. Smoking doubles the risk of developing this cancer. Risk is also dependent on the duration of smoking and the number of cigarettes smoked per day during one's lifetime, and heavy smokers have the highest incidence of these cancers.

In smokers with less than 10 years of exposure to cigarette smoking, the risk of advanced disease increased by 6% compared with non-smokers; however 10 to 20 and 20 to 30 years of exposure increased the risk by 44% and 71%, respectively. According to the recent data, the risk of developing renal cell carcinoma was 36% higher in current smokers and 16% higher in former smokers compared with the risk in never smokers.

The actual mechanisms of how smoking affects cancer growth are unknown.

Tobacco smoke has long been associated with genetic mutations, inflammation, and cellular damage, all of which fuel cancer growth. Smoking causes inflammation in blood vessels thus increasing atherosclerosis a process causing blockages in blood vessels leading to worsening of blood pressure and kidney disease. Smoking can also interfere with medicines used to treat high blood pressure, leading to poor control of blood pressure and further increasing the risk of kidney cancers, as high blood pressure and obesity are the other two most important risk factors for kidney disease. 

Recently studies have suggested that smoking may be associated with renal cell cancer-related mortality, which indicates that cigarette smoking may not only be implicated in causing renal cell cancer, but also promotes cancer progression that translates into more advanced disease in smokers. Moreover, smokers had a more aggressive disease and more advanced tumours at presentation. Current and former smokers were more likely than non-smokers to have advanced renal cancer, defined as a tumor that involves the lymph nodes or has otherwise spread. 

Advanced malignancies are much more lethal than early-stage renal cancers. Only 8 percent of patients with the most severe form of renal cancer survive five years, according to the American Cancer Society, while five-year survival rates top 70 percent among early stages of kidney cancer. Not only that, Patients diagnosed with metastatic or widespread renal cell cancers who continue to smoke significantly reduce their overall survival, and their life span is shorter than those of non-smokers.

Still, there is a ray of hope and sunshine, that sustained smoking cessation can revert these risk factors over time. This should provide the general public with a reason to quit smoking. Earlier individual leaves smoking lower is his risk of developing cancer. If at all he quits smoking after getting the disease, after quitting his response to treatment becomes better, his survival improves with treatment and he is able to live longer. So one must Quit Smoking at whatever stage they can, and whenever the awakening happens to them. This will ensure a healthy life for themselves and their families.

(Dr. Anuja Porwal, Additional Director & HOD - Nephrology & Kidney Transplant, Fortis Hospital Noida)

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