Maintain a high index of suspicion for kidney cancer

Research output: Contribution to journalArticlepeer-review

Abstract

Kidney cancer accounts for 4% of total malignancies in men and 3% in women. More than 80% of kidney cancers are renal cell carcinomas (RCC). Early stage and localised disease is potentially curable in around 90% of patients. However, metastatic disease has historically been associated with poor prognosis; 10% survival at five years post diagnosis. More than 50% of RCC cases are detected incidentally on imaging, often at a late stage. Patients may present with mass-related localised symptoms, constitutional symptoms and symptoms of metastatic disease. There is a male predominance for RCC in a ratio of 3:2. Incidence increases with advancing age with more than 50% of cases diagnosed in people aged over 70. Risk factors include smoking, obesity and hypertension. Patients with acquired cystic kidney disease, those with end-stage renal disease, patients receiving haemodialysis or who have had a renal transplant are all at an increased risk of RCC. Ultrasound is the optimal initial investigation to screen individuals with suspected RCC. NICE recommends that patients aged 45 and over with isolated haematuria, in the absence (or following treatment) of a urinary tract infection, are referred for investigation of a potential renal malignancy.
Original languageEnglish
Pages (from-to)21-24
JournalThe Practitioner
Volume266
Issue number1857
Publication statusPublished - 25 Apr 2022

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