Rising incidence of renal cell cancer in the United States

Context Clinical surveys have revealed that incidental detection of renal c ell carcinoma is rising because of increased use of imaging procedures. Objective To examine incidence, mortality, and survival trends of renal cel l and renal pelvis cancers by age, sex, race, and tumor stage at diagnosis, Design Calculation of age-adjusted incidence and mortality rates, along wit h 5-year relative survival rates, using data from the National Cancer Insti tute's Surveillance, Epidemiology, and End Results (SEER) program. Setting and Participants Patients diagnosed as having kidney cancer from 19 75 through 1995 in the 9 geographic areas covered by tumor registries in th e SEER program, which represent about 10% of the US population. Main Outcome Measures Incidence, mortality, and 5-year relative survival ra tes by time periods, Results The age-adjusted incidence rates for renal cell carcinoma between 1 975 and 1995 for white men, white women, black men, and black women were 9. 6, 4.4, 11.1, and 4.9 per 100 000 person-years, respectively. The correspon ding rates for renal pelvis cancer were 1.5, 0.7, 0.8, and 0.5 per 100 000 person-years, Renal cell cancer incidence rates increased steadily between 1975 and 1995, by 2.3% annually among white men, 3.1% among white women, 3. 9% among black men, and 4.3% among black women. Increases were greatest for localized tumors but were also seen for more advanced and unstaged tumors. In contrast, the incidence rates for renal pelvis cancer declined among wh ite men and remained stable among white women and blacks. Although 5-year r elative survival rates for patients with renal cell cancer improved among w hites but not among blacks, kidney cancer mortality rates increased in all race and sex groups. Conclusions Increasing detection of presymptomatic tumors by imaging proced ures, such as ultrasonography, computed tomography, and magnetic resonance imaging, does not fully explain the upward incidence trends of renal cell c arcinoma. Other factors may be contributing to the rapidly increasing incid ence of renal cell cancer in the United States, particularly among blacks.