Contemporary epidemiology of renal cell cancer

Abstract

We analyzed renal cell cancer incidence patterns in the United States and reviewed recent epidemiologic evidence with regard to environmental and host genetic determinants of renal cell cancer risk. Renal cell cancer incidence rates continued to rise among all racial/ethnic groups in the United States, across all age groups, and for all tumor sizes, with the most rapid increases for localized stage disease and small tumors. Recent cohort studies confirmed the association of smoking, excess body weight, and hypertension with an elevated risk of renal cell cancer, and suggested that these factors can be modified to reduce the risk. There is increasing evidence for an inverse association between renal cell cancer risk and physical activity and moderate intake of alcohol. Occupational exposure to trichloroethylene has been positively associated with renal cell cancer risk in several recent studies, but its link with somatic mutations of the von Hippel-Lindau gene has not been confirmed. Studies of genetic polymorphisms in relation to renal cell cancer risk have produced mixed results, but genome-wide association studies with larger sample size and a more comprehensive approach are underway. Few epidemiologic studies have evaluated risk factors by subtypes of renal cell cancer defined by somatic mutations and other tumor markers.

Figure 1

Age-specific incidence rates of microscopically-confirmed renal cell carcinoma by racial/ethnic group and sex, SEER-12 1992–2005.

Figure 2

Trends in age-adjusted (2000 US standard) microscopically-confirmed renal cell carcinoma incidence rates by sex among whites and blacks in SEER-9 during 1977–81 to 2002–05 and among Asian/Pacific Islanders and Hispanics in SEER-12 during 1992–96 to 2002–05.

Figure 3

Trends in age-adjusted (2000 US standard) microscopically-confirmed renal cell carcinoma incidence rates by age group among whites and blacks in SEER-9 during 1977–81 to 2002–05 and among Asian/Pacific Islanders and Hispanics in SEER-12 during 1992–96 to 2002–05.

Figure 4

Trends in age-adjusted (2000 US standard) microscopically-confirmed renal cell carcinoma incidence rates by stage of disease among whites and blacks in SEER-9 during 1977–81 to 2002–05 and among Asian/Pacific Islanders and Hispanics in SEER-12 during 1992–96 to 2002–05.

Figure 5

Trends in age-adjusted (2000 US standard) microscopically-confirmed renal cell carcinoma incidence rates by size of tumor among whites and blacks in SEER-9 during 1977–81 to 2002–05 and among Asian/Pacific Islanders and Hispanics in SEER-12 during 1992–96 to 2002–05.