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Review
. 2018 Sep;36(9):1341-1353.
doi: 10.1007/s00345-018-2286-7. Epub 2018 Apr 2.

Epidemiology and screening for renal cancer

Sabrina H Rossi  1 , Tobias Klatte  2 , Juliet Usher-Smith  3 , Grant D Stewart  4
Affiliations
Review

Epidemiology and screening for renal cancer

Sabrina H Rossi et al. World J Urol. 2018 Sep.

Abstract

Purpose: The widespread use of abdominal imaging has affected the epidemiology of renal cell carcinoma (RCC). Despite this, over 25% of individuals with RCC have evidence of metastases at presentation. Screening for RCC has the potential to downstage the disease.

Methods: We performed a literature review on the epidemiology of RCC and evidence base regarding screening. Furthermore, contemporary RCC epidemiology data was obtained for the United Kingdom and trends in age-standardised rates of incidence and mortality were analysed by annual percentage change statistics and joinpoint regression.

Results: The incidence of RCC in the UK increased by 3.1% annually from 1993 through 2014. Urinary dipstick is an inadequate screening tool due to low sensitivity and specificity. It is unlikely that CT would be recommended for population screening due to cost, radiation dose and increased potential for other incidental findings. Screening ultrasound has a sensitivity and specificity of 82-83% and 98-99%, respectively; however, accuracy is dependent on tumour size. No clinically validated urinary nor serum biomarkers have been identified. Major barriers to population screening include the relatively low prevalence of the disease, the potential for false positives and over-diagnosis of slow-growing RCCs. Individual patient risk-stratification based on a combination of risk factors may improve screening efficiency and minimise harms by identifying a group at high risk of RCC.

Conclusion: The incidence of RCC is increasing. The optimal screening modality and target population remain to be elucidated. An analysis of the benefits and harms of screening for patients and society is warranted.

Keywords: Early detection; Renal cell carcinoma; Review; Screening; Ultrasound.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no relevant conflict of interest.

Research involving human participants and/or animals

The following manuscript is a review of existing data. Therefore, this article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study (review) formal consent is not required.

Figures

Fig. 1
Fig. 1
Age-standardised renal cell carcinoma incidence rates according to gender (a) and age group (b) in the UK population between 1993 and 2014. Incidence rates rose continuously (average annual percentage change 3.1%), especially in the elderly. In contrast, mortality rates (c) increased only to a minor extent (average annual percentage change 1.1%), indicating improvements in relative survival
See this image and copyright information in PMC

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