EPIDEMIOLOGY
Kidney cancer or renal cell carcinoma is reasonably common. The incidence of kidney cancer in North America is approximately 64,000 per year and 84,000 cases per year in Europe. Kidney cancer is 50 percent more common in men compared with women and predominantly occurs in the sixth to eight decade of life. The five-year survival rate of patients is 73 percent from 2005 to 2011 and the incidence of RCC has risen threefold higher than the mortality rate. This improved survival and case-fatality rate is mostly due to earlier detection of small renal tumours by imaging.
ESTABLISHED RISK FACTORS
Smoking — Cigarette smoking is associated with increase risk of developing renal cell carcinoma (RCC). There is evidence that increasing usage is associated with pathologically more advanced disease at presentation.
Hypertension — High blood pressure is an indepandent risk fact for developing renal cell carcinoma.
Obesity — Excessive body weight is a risk factor for RCC in both men and women.
OTHER RISK FACTORS
Acquired cystic disease of the kidney — The risk of developing RCC has been estimated to be 30 times greater in dialysis patients with acquired polycystic disease of the kidney than in the general population.
Analgesics — The prolonged ingestion of analgesic combinations, particularly compounds containing phenacetin and aspirin, can lead to chronic renal failure. Such patients are at increased risk for renal pelvic and urothelial tumours.
Genetic factors — The risk of a second, metachronous RCC is increased in patients who have been treated for one renal cancer. This increased risk is most pronounced with younger age at the first RCC, suggesting that early onset renal cancer has a genetic component.
Cytotoxic chemotherapy — The use of cytotoxic chemotherapy in childhood for malignancies, autoimmune disorders, or bone marrow transplant conditioning has been associated with the subsequent development of translocation RCC.
Chronic hepatitis C infection — chronic infection with hepatitis C virus was associated with a significantly increased risk of RCC after correcting for age, ethnicity, gender, and the presence of chronic kidney disease
Sickle cell disease — Patients with sickle cell trait are at risk for renal medullary carcinoma.
Kidney stones — A history of kidney stones may be associated with both RCC and transitional cell carcinoma of the upper urinary tract and the increased risk appeared to be largely limited to men.
OTHER RISK MODIFIER
Diabetes mellitus — A history of diabetes mellitus has been associated with a modest increase in the risk of renal cell carcinoma (RCC) in some studies but not in others. This may be mediated through an increase in the incidence of hypertension.
Polycystic kidney disease — When RCC occurs in the context of polycystic kidney disease, it has a number of different clinical characteristics even though it does not appear to occur with increased frequency compared with the general population. The tumors are more often bilateral at presentation (12 versus 1 to 4 percent in sporadic RCC in the general population), multicentric (28 versus 6 percent), and sarcomatoid in type (33 versus 1 to 5 percent).
Alcohol — Alcohol intake is associated with a protective effect on the risk of RCC in both men and women
