Wednesday, September 26, 2012

Renal Cell Carcinoma - A Reappraisal part 2


Incidence


The incidence of RCC is increasing in the United States (Lynch, West, Davila & Platz, 2007). The incidence of RCC is slightly higher among African Americans than the Caucasian population. In 2011, there were approximately 60,920 new cases of kidney cancer reported in the United States (37,120 males and 23,800 females), which resulted in about 13,120 deaths (8,270 males and 4,850 females) (American Cancer Society, n.d.). RCC incidence rates increased steadily between 1975 and 1995, by 2.3% annually among Caucasian men, 3.1% among Caucasian women, 3.9% among African-American men, and 4.3% among African-American women (Chow, Devesa, Warren, & Fraumeni, 1999). Since then, the annual incidence rate has steadily increased by 2.6% (National Cancer Institute [NCI], 2011).
A likely cause for the increase in the incidence of RCC is the widespread use of abdominal imaging in the last 15 to 20 years. Pantuck, Zisman, and Belldegrun (2001) commented that less than 10% of RCCs were detected incidentally in the 1970s compared to the over 60% detected incidentally in 1998. The historical classic triad of flank pain, hematuria, and abdominal mass is seen infrequently because many patients are being diagnosed incidentally (Jayson & Sanders, 1998). Symptoms, if present, may be the result of local tumor growth, hemorrhage, metastatic disease, or paraneoplastic syndromes found in 20% of patients with RCC, with the most common being hypertension, polycythemia, and hypercalcemia (Gold, Fefer, & Thompson 1996; Sufrin, Chasan, Golio, & Murphy 1989).

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