在美国，肾细胞癌（RCC）的发病率和已确认是RCC风险因素的肥胖症患病率已经增长了几十年。RCC在老年人中更为常见。我们希望量化过度脂肪对60岁或以上个体中RCC发病率上升的贡献。我们使用NIH-AARP饮食与健康研究数据（n = 453,859参与者，1995-1996年招募，入组时年龄为50-71岁）来估算跨BMI分类的多元调整危险比（HR）和吸烟相关的HR。通过使用国家健康采访调查（1985-2008年）得到的超重/肥胖患病率和估算的HR来计算人群可归因分数（PAFs）。PAF估计与监测、流行病学和最终结果13中的RCC发病率相结合，以计算与超重/肥胖有关（不相关）的RCC发病率的年度百分比变化。我们发现，在1995年至2018年间，在60岁及以上个体中，对于所有RCCs，超重/肥胖的PAF从18％增加到29％。相比之下，吸烟的PAF从12％下降到9％。总体上，RCC发病率每年增加1.8％（95％置信区间（CI）1.5-2.1％），而超重/肥胖所致的RCC发病率每年增加3.8％（95％CI 3.5-4.2％），与超重/肥胖无关的RCC发病率每年增加1.2％（95％CI 0.9-1.4）。总之，自1990年代中期以来，超重/肥胖似乎已重要贡献了RCC在美国的发病率上升。针对减少超重和肥胖的公共卫生干预可能有助于大大遏制这一趋势。本文受版权保护。保留所有权利。

In the U.S., renal cell carcinoma (RCC) incidence and the prevalence of obesity, an established risk factor for RCC, have been increasing for several decades. RCC is more common among older individuals. We sought to quantify the contribution of excess adiposity to the rising incidence of RCC among individuals 60 years or older. NIH-AARP Diet and Health Study data (n=453,859 participants, enrolled in 1995-1996, age at enrollment 50-71 years) were used to estimate multivariable-adjusted hazard ratios (HRs) for RCC across body mass index categories and HRs associated with smoking. Population attributable fractions (PAFs) were calculated using estimated HRs and annual overweight/obesity prevalence from the National Health Interview Survey (1985-2008). PAF estimates were combined with RCC incidence from Surveillance, Epidemiology, and End Results-13 to calculate annual percent changes in RCC incidence attributable (and unrelated) to overweight/obesity. We found that between 1995 and 2018, among individuals aged 60 years and older, PAF for overweight/obesity increased from 18% to 29% for all RCCs. In comparison, the PAF for smoking declined from 12% to 9%. RCC incidence increased 1.8% per year (95% confidence interval (CI) 1.5-2.1%) overall, while RCC incidence attributable to overweight/obesity increased 3.8% per year (95%CI 3.5-4.2%) and RCC incidence unrelated to overweight/obesity increased 1.2% per year (95%CI 0.9-1.4). In conclusion, overweight/obesity appears to have contributed importantly to the rising incidence of RCC in the U.S. since the mid-1990s. Public health interventions focused on reducing overweight and obesity could help substantially in curbing this trend. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.