In the following I will be discussing kidney cancer causes; first I will deal with some statistics that point to causes of kidney cancer, which I will discuss subsequently.
In the US there are about 29,000 new cases of kidney cancer diagnosed every year and more than 11,700 patients die from this disease in the same time period. Males outnumber females by 1.5 to 1. Kidney cancer is more common in city dwellers than in people living in the country. In the 1970’s and 1980’s there has been an increase of the rate of kidney cancer, but lately the occurrence rate has leveled off and stayed stable (Ref.1).
Cigarette smoking is one of the major causes of kidney cancer.
However, it takes about 20 to 30 years from the beginning of the exposure until the first cancers occur.
There also is a dose-response curve between cancer of the kidneys and the pack/years of cigarettes smoked. About 30% of kidney cancers in men and about 25% of kidney cancers in women can be attributed to smoking. Obesity is directly related to kidney cancer, so is analgesic abuse of aspirin and phenacetin, both available over the counter. The table here lists some other chemical risk factors that can cause kidney cancer after prolonged exposure.
Some chemical risk factors for kidney cancer:
asbestos , cadmium , phenacetin analgesics,
prolonged gasoline exposure , tar , tar products,
thorotrast (old X-ray dye)
In terms of medical conditions that predispose to the development of kidney cancer there is mainly end-stage kidney disease, particularly if there are kidney cysts present. Patients on long-term dialysis tend to develop such cysts. Pathological examination of these cysts revealed that there is hyperplasia that arises from the lining of these cysts and eventually this condition leads to cancer. End-stage kidney disease patients have to be carefully monitored with a series of ultrasonic tests and CT scans to monitor for possible cancerous changes in the kidney condition. There are some genetic diseases that are associated with an increased risk of kidney cancer.
Polycystic kidney disease
This condition is inherited in a direct fashion from the parents. This happens in about 1 in 1000 people born. About 10% of all end stage kidney disease is due to this condition. In 1/3 of the cases there are also cysts in the liver. In about 10% of older patients there are also pouches in the cerebral arteries, called intracranial aneurysms. These patients deteriorate with their kidney function and need kidney dialysis by the age of 55 to 60. This is, as mentioned above, associated with a high risk for developing kidney cancer.
This genetic symptom complex with eye and skin manifestations has often vascular abnormalities in the kidney that deteriorate in time into kidney cancer.
There are other familial conditions,such as the rare von Hippel-Lindau syndromeand familial renal cell carcinoma, which are all different causes of kidney cancer (Ref.1 and 2).
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2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on Cancer of the kidney and ureter.
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