Elsevier

European Urology

Volume 60, Issue 4, October 2011, Pages 615-621
European Urology

Special Edition EAU–ICUD – Review – Kidney Cancer
The Epidemiology of Renal Cell Carcinoma

https://doi.org/10.1016/j.eururo.2011.06.049Get rights and content

Abstract

Context

Kidney cancer is among the 10 most frequently occurring cancers in Western communities. Globally, about 270 000 cases of kidney cancer are diagnosed yearly and 116 000 people die from the disease. Approximately 90% of all kidney cancers are renal cell carcinomas (RCC).

Objective

The causes of RCC are not completely known. We have reviewed known aetiologic factors.

Evidence acquisition

The data provided in the current review are based on a thorough review of available original and review articles on RCC epidemiology with a systemic literature search using Medline.

Evidence synthesis

Smoking, overweight and obesity, and germline mutations in specific genes are established risk factors for RCC. Hypertension and advanced kidney disease, which makes dialysis necessary, also increase RCC risk. Specific dietary habits and occupational exposure to specific carcinogens are suspected risk factors, but results in the literature are inconclusive. Alcohol consumption seems to have a protective effect for reasons yet unknown. Hardly any information is available for some factors that may have a high a priori role in the causation of RCC, such as salt consumption.

Conclusions

Large collaborative studies with uniform data collection seem to be necessary to elucidate a complete list of established risk factors of RCC. This is necessary to make successful prevention possible for a disease that is diagnosed frequently in a stage where curative treatment is not possible anymore.

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

References (50)

  • D. Cohen et al.

    Molecular genetics of familial renal cell carcinoma syndromes

    Clin Lab Med

    (2005)
  • U. Athar et al.

    Treatment options for metastatic renal cell carcinoma: a review

    Can J Urol

    (2008)
  • J. Ferlay et al.

    Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008

    Int J Cancer

    (2010)
  • F. Levi et al.

    The changing pattern of kidney cancer incidence and mortality in Europe

    BJU Int

    (2008)
  • W.H. Chow et al.

    Contemporary epidemiology of renal cell cancer

    Cancer J

    (2008)
  • J.D. Hunt et al.

    Renal cell carcinoma in relation to cigarette smoking: meta-analysis of 24 studies

    Int J Cancer

    (2005)
  • K.F. Adams et al.

    Body size and renal cell cancer incidence in a large US cohort study

    Am J Epidemiol

    (2008)
  • T. Pischon et al.

    Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC)

    Int J Cancer

    (2006)
  • W.H. Chow et al.

    Obesity, hypertension, and the risk of kidney cancer in men

    N Engl J Med

    (2000)
  • S. Weikert et al.

    Blood pressure and risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition

    Am J Epidemiol

    (2008)
  • L.R. Miller et al.

    Acquired renal cystic disease in end stage renal disease: an autopsy study of 155 cases

    Am J Nephrol

    (1989)
  • M.A. Nouh et al.

    Renal cell carcinoma in patients with end-stage renal disease: relationship between histological type and duration of dialysis

    BJU Int

    (2010)
  • W.H. Chow et al.

    Risk of urinary tract cancers following kidney or ureter stones

    J Natl Cancer Inst

    (1997)
  • A.S. Parker et al.

    History of urinary tract infection and risk of renal cell carcinoma

    Am J Epidemiol

    (2004)
  • W.H. Chow et al.

    Epidemiology and risk factors for kidney cancer

    Nat Rev Urol

    (2010)
  • Cited by (0)

    View full text