Objectives: To explore the relationship between renal cell carcinoma rates and health status and behavior in the United States. Methods: The renal cell carcinoma incidence (2003-2004) and mortality rates (2000-2003) for males and females were compared with the levels of current smokers, obesity, physical inactivity, hypertension, diabetes, high fruit/vegetable diet, and excessive alcohol consumption on a state-by-state basis. Family income, lack of health insurance, urbanization, and urologist population density among the states were included to adjust for access to healthcare and socioeconomic status. Results: The renal cell carcinoma incidence and mortality rates for both males and females correlated directly with the levels of smoking, obesity, and physical inactivity. The incidence rates correlated directly with hypertension for both sexes and the urologist population density for males. The mortality rates correlated inversely with high fruit/vegetable consumption, family income, and urbanization for both sexes. Multivariate analysis identified best-fit models for predicting renal cell carcinoma rates. Physical inactivity and urologist population density were the strongest variables for predicting the incidence rates in males; smoking for predicting the incidence rates in females; and smoking and high fruit/vegetable diet for predicting mortality in both sexes. Conclusions: In the present study, we found that smoking, obesity, and physical inactivity correlated directly with the renal cell carcinoma incidence and mortality and hypertension correlated directly with the incidence rates. A high fruit/vegetable diet, family income, and urbanization correlated inversely with renal cell carcinoma mortality rates. The prevalence of urologists correlated directly with the incidence rates for males but not for females.
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