PALO ALTO, CA – Despite its importance, renal cell carcinoma (RCC) tends to be understudied in the United States, according to a new study.
A report in Lancet Regional Health – Americas suggested that California, with its large, racially and socioeconomically diverse population and long-standing, high-quality cancer registry, offers a unique setting for examining temporal trends in RCC incidence and mortality. 1
A study led by Stanford University School of Medicine and the VA Palo Alto, CA, Healthcare System sought to investigate the incidence and mortality rates of first RCC in individuals aged 20 and older in California from 1988 through 2019, including overall trends and by sociodemographic factors.
The study team obtained the data from the California Cancer Registry. From 1988 through 2019, the researchers identified 90,659 incident RCC cases, of which 62.9% were localized at diagnosis, and 37,069 RCC-related deaths.
“Incidence was higher in males than females, among American Indian/Alaska Native, Hispanic, and non-Hispanic Black individuals, and in lower-nSES areas,” the authors wrote. “Incidence rose over time, with steeper increases among Hispanic and non-Hispanic Black populations and in the lowest nSES [neighborhood Socioeconomic Status] groups. Although mortality declined overall, disparities persisted, with Hispanic and non-Hispanic Black individuals experiencing higher mortality than non-Hispanic white individuals.”
The study concluded that RCC remains a significant public health concern in California, “with disparities by race, ethnicity, and nSES widening over time. This underscores the relevance of RCC as a health equity issue and the need for targeted public health action and equity-focused research.”
Background information in the article pointed out that an estimated 80,980 new cases of kidney cancer and 14,510 deaths occurred in 2025. U.S. data from 2010 through 2023 indicated that age-adjusted kidney cancer incidence rates peaked around 2019 and have since stabilized, similar to trends observed in other high-income countries.
“Mortality rates have shown a promising downward trend, with an average annual decline of 0.6% between 1999 and 2020,” the authors advised. “This encouraging change likely signals progress in smoking reduction, advancements in medical treatments (e.g., introduction of immune checkpoint inhibitors and targeted therapy), and other improvements in patient care.”
In California, more than 7,500 new cases of and 1350 deaths from kidney cancer occur each year, with approximately 90% of the cases classified as renal cell carcinoma (RCC). A previous California analysis of RCC incidence and mortality trends, the authors reported a sharp rise in RCC incidence through 2009 that stabilized with mortality tending to decline. “Since that analysis, the introduction of targeted therapies and immune checkpoint inhibitors has revolutionized RCC treatment, substantially improving survival for many patients,” according to the report “Thus, there is a need to update these trends with recent data that reflect contemporary patterns of RCC and new treatment advances and to investigate the burden of RCC across sociodemographic groups within California’s diverse population.”
The study team pointed out that understanding tumor characteristics and treatment trends is essential for evaluating progress against RCC, pointing out that, from 1988 through 2019, clear cell carcinoma was the most common histologic type. Additionally, they noted, 39.1% of cases lacked histologic specification, which reflected documented limitations in tumor characterization and reporting.
“Radical nephrectomy was the predominant primary treatment during the study period overall; partial nephrectomy—despite its nephron-sparing benefits for small, localized tumors—was performed in only 23.3% of cases,” the authors wrote. “Encouragingly, surgical trends showed a shift; while the proportion of individuals receiving total nephrectomies declined after the early 2000s, the percentage of partial nephrectomies steadily increased, reaching parity with total nephrectomies by 2019. This shift likely reflects greater adherence to guidelines and increased awareness of the benefits of partial nephrectomy in preserving renal function and reducing long-term complications, particularly for individuals with localized disease. Further progress is needed to ensure broader uptake of evidence-based surgical practices in RCC care.”
While many indicators were positive, the new findings suggested that the incidence rate of RCC in California has continued to rise in recent years “primarily driven by an increase in localized disease, which accounted for nearly two-thirds of all cases. This may be partly explained by the increased use of imaging in the late 1990s and early 2000s, which led to more frequent incidental detection of small renal tumors. That imaging use began to plateau around 2010,coinciding with a deceleration, but not a reversal, in the rise of incidence rates indicates that other factors may also be contributing. The parallel increase in the prevalence of established RCC risk factors, such as hypertension and obesity, indicates that broader changes in population risk factors may also have contributed to the sustained rise in incidence.”
The study concluded that RCC remains a significant public health concern in the U.S. and emphasized that “ongoing and enhanced surveillance will be necessary to monitor trends, evaluate whether efforts to reduce incidence align with projected declines, and determine if gains in survival are sustained.”
1L’Espérance K, Lin K, Lichtensztajn D, Christoph Soerensen SJ, Gulati S, Deng Z, Leppert JT, Oh DY, Sakoda LC, Washington SL 3rd, Meng MV, Chan JM, Langston ME, Cheng I, Chung BI, Graff RE. Renal cell carcinoma incidence and mortality in California: a population-based study of sociodemographic patterns and temporal trends from 1988 through 2019. Lancet Reg Health Am. 2026 Feb 27;56:101430. doi: 10.1016/j.lana.2026.101430. PMID: 41800233; PMCID: PMC12964298