Epidemiology and Aetiology of Renal Cell Carcinoma

Kidney cancer accounts for 3 % of adult cancers in Western countries .

The origin of the renal cell carcinoma is multifactorial as is the case for most cancers . Studies have identified risk factors associated with age , gender, tobacco use and other associated diseases. In 2% of cases , there is a genetic predisposition .

 

EPIDEMIOLOGY

Renal cell carcinoma (RCC) represents 2-3% of all cancers .  With the highest incidence occurring in Western countries. Generally, during the last two decades until recently, there has been an annual increase of about 2% in incidence both worldwide and in Europe, though in Denmark and Sweden a continuing decrease has been observed. In 2012, there were approximately 84,400 new cases of RCC and 34,700 kidney cancer- related deaths within the European Union.

In Europe, overall mortality rates for RCC have increased up until the early 1990s, with rates generally stabilising or declining thereafter.  There has been a decrease in mortality since the 1980s in Scandinavian countries and since the early 1990s in France, Germany, Austria, the Netherlands, and Italy. However, in some European countries (Croatia, Estonia, Greece, Ireland, Slovakia), mortality rates still show an upward trend with increasing rates.

Renal cell carcinoma is the commonest solid lesion within the kidney and accounts for approximately 90% of all kidney malignancies. It comprises different RCC types with specific histopathological and genetic characteristics. There is a 1.5:1 predominance in men over women, with peak incidence occurring between 60 and 70 years of age.

 

AETIOLOGY 

Aetiological factors include lifestyle such as smoking, obesity, and hypertension . Having a first-degree relative with kidney cancer is also associated with an increased risk of RCC . A number of other factors have been suggested to be associated with higher or lower risk of RCC, but these have not been confirmed. These include specific dietary habits and occupational exposure to specific carcinogens, but results in the literature are inconclusive.

Moderate alcohol consumption appears to have a protective effect for reasons not yet known . The most effective prophylaxis is to avoid cigarette smoking and reduce obesity.

Due to the increased detection of tumours by imaging techniques such as ultrasound (US) and computed tomography (CT), the number of incidentally diagnosed RCCs has increased. These tumours are more often smaller and of lower stage.

 

Recommendation

Several verified risk factors have been identified including smoking, obesity and hypertension. These factors can be considered as definite risk factors for RCC.

The most important primary prevention for RCC is to eliminate cigarette smoking and to reduce obesity.

 

Some bibliographic elements (French)

http://www.artur-rein.org/epidemiologie

http://urofrance.org/fileadmin/documents/data/PU/1997/PU-1997-00070755/TEXF-PU-1997-00070755.PDF

http://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_LR.pdf