California Statistics Indicate Kidney Cancer Rates Might Be Declining Overall

Renal Cell Carcinoma Make Up 90% of VA’s Kidney Cancer Cases

By Annette M. Boyle

SACRAMENTO, CA — After years of apparently rising rates of kidney cancer, the incidence of early-stage disease seems to be declining, at least in California.

A study conducted at the University of California Davis and published in Kidney Cancer is the first to indicate a change in kidney cancer trends and to demonstrate significant changes in treatment.

“The increased incidence of small, localized tumors without a corresponding increase in kidney cancer deaths suggests that the incidence trends, until around 2009, were mostly driven by incidental findings associated with the increased use of advanced diagnostic imaging,” said lead author Cyllene Morris, chief epidemiologist at UC Davis’ Institute for Population Health Improvement.1

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From 1988 to 2000, the incidence of renal cell carcinoma (RCC) nationwide rose approximately 1.5% per year, then spiked to 4.8% until 2008, after which it stabilized, the researchers found. Nearly all of the increase in RCC detected before 2008 occurred at the localized stage, with tumors of less than 4 cm.

Several studies have suggested that the apparent increase could be attributed to the sharp rise in the use of imaging. From 1996 through 2010, the number of ultrasounds performed doubled, while the number of computed tomography scans tripled and use of magnetic resonance imaging quadrupled. From 2004 to 2010, positron emission tomography scans increased 1000%, the authors noted. Since 2010, the use of imaging has largely leveled off and actually declined among privately-insured patients.Kidney cancers, primarily renal cell carcinoma and urothelial renal pelvis cancer, account for about 3.3% of all cancers in veterans. Of those, renal cell carcinoma (RCC) represents about 90% of cases. Within the VA, the rate of RCC has held relatively steady, Michael Kelley, MD, VA’s national program director for oncology told U.S. Medicine last year.

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