Bloody urine," loss of strength, anemia, and sudden weight loss are common symptoms of the deadly disease renal cell carcinoma. Eighty-five percent of kidney cancer cases are related to this disease. Renal cell carcinoma is considered the deadliest urological cancer in the United States.
Seventy-six percent of patients diagnosed with RCC live for about 5 years, while in patients with advanced disease, the survival rate drops to 12%. Researchers have identified 5 risk factors for renal cell carcinoma that clinicians should consider when providing primary care.
The incidence of kidney cancer has more than doubled in recent decades
Kidney cancer accounts for 2.2% of cancer diagnoses worldwide and 1.8% of deaths, and scientists predict that these numbers will only grow. The American Cancer Society estimates that more than 81,000 new cases of kidney cancer will be diagnosed in the United States in 2023, an increase of 5,000 over 2021.
Over the past half-century, kidney cancer has been one of the fastest-growing cancers in the United States. Its incidence has more than doubled from 7.1 cases per 100,000 populations in 1975 to 16.5 cases per 100,000 populations in 2019.
Scientists suggest that the use of cross-sectional imaging, which allows for the detection of cancer, has contributed to the increase in NPC diagnoses.
American Indians and Alaskan Natives are the most affected by IBC.
According to researchers, the risk of developing renal cell carcinoma depends on race and ethnicity. Over the five-year period from 2015 to 2020, 8.1 cases per 100,000 people were diagnosed in Asian Americans and Pacific Islanders, and 31 cases among American Indians and Alaska Natives. The incidence rate among Hispanics and whites is 17.5 and among blacks 19.1 cases per 100,000 populations.
It was found that Latinos and Native Americans with renal cell carcinoma have different characteristics of the disease compared to Americans of European descent. They have a higher proportion of kidney cancer, and the disease is diagnosed at a younger age.
There are also differences in 5-year mortality from kidney cancer between races and ethnicities:
- The overall mortality rate is 3.5 per 100,000 populations and varies from 1.6 in patients of Asian descent and Pacific Islanders to 6.5 per 100,000 populations among American Indians and Alaska Natives.
- Hispanics, blacks, and whites have average mortality rates of 3.3 per 100,000 populations, 3.4, and 3.6, respectively.
Black patients have lower survival rates than patients of European descent. Despite this, the 5-year survival rate for renal cell carcinoma is the same in both groups: 76% for white patients and 77% for black patients as of 2019. The similarity in overall survival rates can be explained by the higher proportion of papillary and chromophobe renal cell carcinoma cases in black patients compared to white patients. These forms of the disease have a more favorable prognosis compared to other types of RCC.
Most often, men over the age of 60 suffer from RCC.
Although kidney cancer affects all people, regardless of gender, men of mature age are much more likely to get sick. The overall incidence of kidney cancer from 2015 to 2020 in men was almost twice as high as in women: 23.5 cases versus 12.0 cases per 100,000 populations.
In the United States, the average age at diagnosis of RCC is 64 years, although most patients are diagnosed between the ages of 65 and 74.
The probability of being diagnosed with kidney cancer increases with age. In men aged 49 years and older, it is 0.3%, in men aged 50-59 years - 0.7%, and in men aged 60-69 years - 1.4%. The risk of developing kidney cancer in women also increases with age: at the age of 49, the probability of the disease is 0.2%, at the age of 50-59 - 0.3%, and 0.8% at the age of 60-69.
- In general, men have a lifetime probability of developing renal cell carcinoma of 2.3%, while the probability for women is twice as low - 1.3%.
Smoking even a few cigarettes a day significantly increases the risk of kidney cancer.
The most significant risk factor for RCC is tobacco smoking. A systematic review of scientists showed that compared to those who have never smoked, the relative risk of kidney cancer among smokers is 1.39, and among former smokers - 1.20. The intensity of smoking increases this risk: for those who smoked 5 cigarettes a day, the risk was 1.18 and 1.72 for those who smoked 30 cigarettes a day. The risk of kidney cancer increased linearly with smoking duration: the relative risk was 1.70 after 25 years of smoking.
Obesity is another risk factor for PCa. According to a meta-analysis, the risk of kidney cancer was increased in patients with a body mass index of more than 30 compared to men with a BMI of 18-25.
An additional 5 kg of body weight can increase the risk of PCa by 25% in men and 35% in women. On the other hand, a study by Japanese scientists showed that a low BMI of less than 21 in Asian men may also increase the risk of kidney cancer.
Hypertension is also associated with an increased risk of kidney cancer. A meta-analysis showed that each 10 mm Hg increase in systolic blood pressure increases the risk of RCC by 5%, and an increase in diastolic blood pressure by 7%.
Comorbid dementia can increase mortality in patients with CKD
The prognosis of renal cell carcinoma can be affected by comorbidities. A study by Danish scientists showed that patients with RCC with a Charlson comorbidity index of 1-2 had higher mortality rates than patients without comorbidities.
The comorbidities that had the greatest impact on the mortality of patients with NCD were liver disease of varying severity and dementia.
Heart failure, peripheral and cerebral vascular disease, chronic lung and kidney disease, as well as diabetes and lymphoma also increased mortality. According to American scientists, in patients over 65 years of age with NKR, the highest mortality risks were observed in those with heart failure and chronic kidney disease. Peripheral vascular disease, chronic obstructive pulmonary disease, diabetes, and cerebrovascular disease also reduced the overall survival of patients with this diagnosis.
As you can see, risk factors for renal cell carcinoma include ethnicity and race, smoking, obesity, hypertension, dementia, and other chronic diseases. The average age of diagnosis is 64 years, and men are diagnosed twice as often as women. As with any type of cancer, the effectiveness of NPC treatment is directly related to early diagnosis, comprehensive therapy, and a healthier lifestyle.