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Review
. 2020 Nov;17(11):637-642.
doi: 10.1038/s41585-020-0363-3. Epub 2020 Aug 28.

Current evidence on screening for renal cancer

Juliet Usher-Smith  1 , Rebecca K Simmons  2 , Sabrina H Rossi  3 , Grant D Stewart  4
Affiliations
Review

Current evidence on screening for renal cancer

Juliet Usher-Smith et al. Nat Rev Urol. 2020 Nov.

Abstract

Renal cell carcinoma (RCC) incidence is increasing worldwide. A high proportion of individuals are asymptomatic at diagnosis, but RCC has a high mortality rate. These facts suggest that RCC meets some of the criteria for screening, and a new analysis shows that screening for RCC could potentially be cost-effective. Targeted screening of high-risk individuals is likely to be the most cost-effective strategy to maximize the benefits and reduce the harms of screening. However, the size of the benefit of earlier initiation of treatment and the overall cost-effectiveness of screening remains uncertain. The optimal screening modality and target population is also unclear, and uncertainties exist regarding the specification and implementation of a screening programme. Before moving to a fully powered trial of screening, future work should focus on the following: developing and validating accurate risk prediction models; developing non-invasive methods of early RCC detection; establishing the feasibility, public acceptability and potential uptake of screening; establishing the prevalence of RCC and stage distribution of RCC detected by screening; and evaluating the potential harms of screening, including the impact on quality of life, overdiagnosis and over-treatment.

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Conflict of interest statement

Competing interests

GDS has received educational grants from Pfizer, AstraZeneca and Intuitive Surgical; consultancy fees from Pfizer, Merck, EUSA Pharma and CMR Surgical; travel expenses from Pfizer and speaker fees from Pfizer. RKS is the Chair of the International Advisory Board for the Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation.

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