Special Edition EAU–ICUD – Review – Kidney CancerThe Epidemiology of Renal Cell Carcinoma
Introduction
Renal cell carcinoma (RCC) accounts for approximately 90% of all renal malignancies. Despite advances in diagnosis, especially improved imaging techniques and the incidental diagnosis of many tumours with imaging tests for unrelated complaints, about 20–30% of all patients are diagnosed with metastatic disease [1]. In addition, another 20% of patients undergoing nephrectomy will have a relapse and develop metastatic RCC (mRCC) during follow-up [2]. For patients with mRCC, the prognosis is extremely poor, which makes the occurrence of mRCC a serious problem for oncologic health care around the world [1]. The overall increasing trend in incidence seems to have peaked, and in some countries even a decrease in incidence and mortality has been registered. The causes of RCC are poorly understood, but specific lifestyle factors such as obesity are very important aetiologic factors.
Section snippets
Evidence acquisition
The data provided in this article are based on a thorough review of available original and review articles on RCC epidemiology via a systemic literature search using Medline.
Incidence and mortality
Worldwide, kidney cancer is the 13th most common malignancy, with approximately 271 000 new cases diagnosed in 2008 [3]. The incidence of kidney cancer varies geographically: Rates of kidney cancer are highest in Europe, North America, and Australia, whereas rates are low in India, Japan, Africa, and China. Until a few years ago, worldwide incidence increased by about 2% yearly. In 2008, about 88 400 new cases of kidney cancer occurred in Europe [4], making it the 10th most common cancer. In
Conclusions
After decades of increasing trends in RCC incidence and mortality rates, it seems that rates are stabilising or starting to decline in many Western countries. This is probably the late result of declining smoking prevalence during the last few decades as well as improved occupational hygiene. Relatively few advances have been witnessed in clinical care of RCC in the past decades. Further progress can still best be achieved in the field of prevention. In most Western countries, 15–35% of the
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