Incidence and Distribution of New Renal Cell Carcinoma Cases: 27-Year Trends from a Statewide Cancer Registry

Main Article Content

Ahmad N. Alzubaidi
Stephen Sekoulopoulos
Jonathan Pham
Vonn Walter
Jay G. Fuletra
Jay D. Raman

Keywords

diagnosis, kidney cancer, renal cell carcinoma, statewide

Abstract

Nationwide databases have implicated an increased incidence of renal cell carcinoma (RCC). The Pennsylvania (PA) Cancer Registry was queried to better define incidence, geographic distribution, and statewide trends of new RCC cases over a 27-year period. JoinPoint Trend Analysis Software modeled average annual percent changes (APCs) in age-adjusted rates (AAR). Maps plotting county-level incidence rates and stage distribution of disease across the state in 5-year time intervals were created using R 4.0.2 software. Overall, 59,628 cases of RCC were recorded in PA from 1990 to 2017. Eighty six percent of patients were >50 years of age, 61% were males, and 89% were Caucasian. Stage distribution using the SEER staging system included 64% local, 17% regional, and 16% distant. Over the study interval, AAR of all RCC cases increased from 9.9 to 18.0 patients per 100,000 population with an APC of 2.3% (p < 0.01). AAR of local disease increased from 5.4 to 12.7 patients per 100,000 population with an APC of 3.2% (p < 0.01). AAR of regional disease also increased from 1.9 to 2.9 patients per 100,000 population with an APC of 1.0% (p = 0.01). Younger patients (<50 years) had a greater rate of increase than older counterparts (APC 3.8% vs. 2.0%, p < 0.05). Geospatial investigation of new RCC cases noted certain geographic concentrations of greater disease incidence. The incidence of RCC in PA has increased over the past 27 years in PA. One-third of the cases are regional or metastatic at presentation and rates of increase were most notable in younger patients.

Abstract 301 | PDF Downloads 274 HTML Downloads 64 XML Downloads 5

References

1. Ferlay J, Shin H-R, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer. 2010;127(12):2893–917. 10.1002/ijc.25516

2. Nepple KG, Yang L, Grubb RL, Strope SA. Population based analysis of the increasing incidence of kidney cancer in the United States: Evaluation of age specific trends from 1975 to 2006. J Urol. 2012;187(1):32–8. 10.1016/j.juro.2011.09.028

3. Cancer of the kidney and renal pelvis—Cancer stat facts [Internet]. SEER; n.d. Available from: https://seer.cancer.gov/statfacts/html/kidrp.html. January 13th, 2022.

4. Centers for Disease Control and Prevention. USCS data visualizations—CDC [Internet]. Centers for Disease Control and Prevention; n.d. Available from: https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/

5. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. Cancer J Clinicians. 2021;71(1):7. 10.3322/caac.21654

6. Moch H, Gasser T, Amin MB, Torhorst J, Sauter G, Mihatsch MJ. Prognostic utility of the recently recommended histologic classification and revised TNM staging system of renal cell carcinoma. Cancer. 2000;89(3):604–14. 10.1002/1097-0142(20000801)89:3%3C604::AID-CNCR16%3E3.0.CO;2-Q

7. Amin MB, Amin MB, Tamboli P, Javidan J, Stricker H, Venturina MD-P, et al. Prognostic impact of histologic subtyping of adult renal epithelial neoplasms. Am J Surg Pathol. 2002;26(3):281–91. 10.1097/00000478-200203000-00001

8. Bosetti C, Bertuccio P, Chatenoud L, Negri E, La Vecchia C, Levi F. Trends in mortality from urologic cancers in Europe, 1970–2008. Eur Urol. 2011;60(1):1–15. 10.1016/j.eururo.2011.03.047

9. Pennsylvania Department of Health. (2021). Cancer Statistics Dashboard. Retrieved September 21, 2021, from https://app.powerbigov.us/view?r=eyJrIjoiYjk3ZmFlMmYtODU3NS00MzU0LTliZDMtZjUyMDcwMjFiNzgxIiwidCI6IjQxOGUyODQxLTAxMjgtNGRkNS05YjZjLTQ3ZmM1YTlhMWJkZSJ9

10. National Cancer Institute. (2021). Cancer of the kidney and renal pelvis - cancer stat facts. Retrieved September 23rd, 2021 from https://seer.cancer.gov/statfacts/html/kidrp.html

11. Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester RJ, Burger M, et al. European Association of Urology guidelines on upper urinary tract urothelial carcinoma: 2017 Update. Eur Urol. 2018;73(1):111. 10.1016/j.eururo.2017.07.036

12. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. 10.3322/caac.21590

13. Joinpoint Regression Program, Version 4.8.0.1—April 2020. Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute. July 20th, 2021

14. Saad AM, Gad MM, Al-Husseini MJ, Ruhban IA, Sonbol MB, Ho TH. Trends in renal-cell carcinoma incidence and mortality in the United states in the last 2 decades: A SEER-based study. Clin Genitourinary Cancer. 2019;17(1). 10.1016/j.clgc.2018.10.002

15. Du Z, Chen W, Xia Q. Trends and projections of kidney cancer incidence at the global and national levels, 1990–2030: A Bayesian age-period-cohort modeling study. Biomark Res. 2020;8:16. 10.1186/s40364-020-00195-3

16. Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of renal cell carcinoma. Eur Urol. 2019;75(1):74–84. 10.1016/j.eururo.2018.08.036

17. Kidney cancer statistics. Cancer Research UK. Retrieved September 23, 2021, from http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/kidney-cancer/incidence-heading-Zero.

18. King SC, Pollack LA, Li J, King JB, Master VA. Continued increase in incidence of renal cell carcinoma, especially in young patients and high grade disease: United States 2001 to 2010. J Urol. 2014;191:1665–70. 10.1016/j.juro.2013.12.046

19. Maehara CK, Silverman SG, Lacson R, Khorasani R. Journal club: Renal masses detected at abdominal ct: Radiologists’ adherence to guidelines regarding management recommendations and communication of critical results. Am J Roentgenol. 2014 Oct; 203(4):828–834. 10.2214/AJR.13.11497

20. Welch HG, Skinner JS, Schroeck FR, Zhou W, Black WC. Regional variation of computed tomographic imaging in the United States and the risk of nephrectomy. JAMA Intern Med. 2018;178(2):221. 10.1001/jamainternmed.2017.7508

21. Kirsch TD, Hsieh YH, Horana L, et al. Computed tomography scan utilization in emergency departments: A multi-state analysis. J Emerg Med. 2010;41:302. 10.1016/j.jemermed.2010.06.030

22. Tsivian M, Moreira DM, Caso JR, Mouraviev V, Polascik TJ. Cigarette smoking is associated with advanced renal cell carcinoma. J Clin Oncol. 2011;29(15):2027–31. 10.1200/JCO.2010.30.9484

23. Hunt JD, van der Hel OL, McMillan GP et al. Renal cell carcinoma in relation to cigarette smoking: Meta-analysis of 24 studies. Int J Cancer. 2005 Mar 10; 114(1): 101–108. 10.1002/ijc.20618

24. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91. 10.1001/jama.2016.6458

25. Choi Y, Park B, Jeong BC, Seo SI, Jeon SS, Choi HY, et al. Body mass index and survival in patients with renal cell carcinoma: A clinical-based cohort and meta-analysis. Int J Cancer. 2013;132(3):625–34. 10.1002/ijc.27639

26. Dobbins M, Decorby K, Choi BC. The association between obesity and cancer risk: A meta-analysis of observational studies from 1985 to 2011. ISRN Prev Med. 2013:680536. 10.5402/2013/680536

27. Graff RE, Sanchez A, Tobias DK, Rodríguez D, Barrisford GW, Blute ML, et al. Type 2 diabetes in relation to the risk of renal cell carcinoma among men and women in two large prospective cohort studies. Diabetes Care. 2018;41(7):1432–7. 10.2337/dc17-2518

28. Otunctemur A, Ozbek E, Sahin S, Dursun M, Besiroglu H, Koklu I, et al. Diabetes mellitus as a risk factor for high grade renal cell carcinoma. Asian Pac J Cancer Prev. 2014;15(9):3993–6. 10.7314/APJCP.2014.15.9.3993