Contemporary Age-Adjusted Incidence and Mortality Rates of RCC
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Recent data showed that North America has the highest incidence of renal cell carcinoma (RCC) worldwide.
OBJECTIVE
To assess contemporary gender-, race-, and stage-specific incidence; survival rates; and trends of RCC patients in the USA.
DESIGN, SETTING, AND PARTICIPANTS
Within the Surveillance, Epidemiology, and End Results database (2001-2016), all patients aged ≥18 yr with histologically confirmed renal parenchymal tumors were included.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
Age-adjusted incidence rates and 5-yr cancer-specific survival (CSS) rates were estimated. Temporal trends were calculated through Joinpoint regression analyses to describe the average annual percent change (AAPC).
RESULTS AND LIMITATIONS
The age-adjusted incidence rate of RCC was 11.3/100 000 person years (AAPC+2.0%, p<0.001). Five-year CSS rates increased from 78.4% to 84.5% (AAPC +0.8%, p<0.001). Male incidence was double that of females (15.5 and 7.7, respectively). CSS marginally favored females (84.5% vs 82.0%), but improved equally in both genders (both AAPC +0.8%). The highest incidence (14.1/100 000 person years, AAPC +2.8%) and lowest survival (80.1%) were recorded in non-Hispanic American Indian/Alaska Native populations. T1aN0M0 had the highest incidence rates (4.6/100 000 person years), the highest increase over time (AAPC +3.6%), and the highest CSS (97.6%) of all stages. Limitations include retrospective nature and lack of information on risk factors.
CONCLUSIONS
The incidence of RCC increased significantly from 2001 to 2016, and 5-yr CSS after RCC improved. This was mainly due to T1aN0M0 tumors that showed the highest increase in the incidence and highest CSS. Unfavorable outcomes in specific ethnic groups warrant further research.
PATIENT SUMMARY
We examined contemporary incidence and cancer-specific survival rates of kidney cancer. Males had double the incidence rates of females, but lower survival. Natives showed the highest incidence rates and the lowest survival rates. Small renal masses showed the highest incidence and survival rates.
Additional Info
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Contemporary Age-Adjusted Incidence and Mortality Rates of Renal Cell Carcinoma: Analysis According to Gender, Race, Stage, Grade, and Histology
Eur Urol Focus 2020 May 23;[EPub Ahead of Print], C Palumbo, A Pecoraro, S Knipper, G Rosiello, S Luzzago, M Deuker, Z Tian, SF Shariat, C Simeone, A Briganti, F Saad, A Berruti, A Antonelli, PI KarakiewiczFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
In this analysis of the SEER database, a large database that covers more than one-third of the US population, the authors investigated the age-adjusted incidence rates and 5-year survival rates of RCC across patient demographics and disease factors using. From 2001 to 2016, a total of 160,381 cases of RCC were identified. During the study period, the age-adjusted incidence rate increased from 9.2 per 100,000 person-years in 2001 to 12.5 per 100,000 person-years in 2016. Incidence rates increased significantly in both men and women at virtually the same rate (average annual percent change, or AAPC, +1.9% and +1.8%, respectively). Time trend analyses showed that RCC incidence rates increased significantly in all race groups, with non-Hispanic American Indian/Alaska Native having the greatest increase (AAPC, +2.8%), followed by Hispanic (AAPC, +2.4%), and non-Hispanic Asian or Pacific Islander (AAPC, +2.3%).
Patients with T1aN0M0 disease had the highest incidence rates (4.6/100,000 person-years), the highest increase over time (AAPC, +3.6%), and the highest cancer-specific survival (CSS; 97.6%) of all stages. The 5-year CSS rates increased from 78.4% to 84.5% (AAPC, +0.8%; P < .001,) with this increase derived from an increase in survival rates of T1-T3N0M0 tumors. G2 tumors had the highest age-adjusted incidence rates (4.5 cases per 100,000 person-years), followed by G3 (2.4), GX (2.6), G1 (1.2), and G4 (0.6).
This report provides a contemporary analysis on incidence and survival rates in a large US population database. Notably, incidence is increasing for RCC, with specific racial groups seeing a greater increase in incidence. T1a tumors had the highest incidence rates, with an increase in 5-year CSS from localized tumors, which is likely a reflection of earlier detection. Furthermore, the improvement in survival among patients with localized tumors may possibly be due to lead-time and length-time biases that are introduced by earlier diagnosis with axial imaging. The SEER database relied on data-collecting protocols, missing information on stage and grade, as well as nonstandardized histopathological review, which may represent biases to this type of study. However, this study provides insight in that ethnic groups may harbor renal cancers that are different in biology and aggressiveness, which warrants further study.