Rising incidence of renal cell cancer in the United States
Rising incidence of renal cell cancer in the United States
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DOI：
10.1001/jama.281.17.1628
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发表时间：
1999-05-05
影响因子：
120.7
通讯作者：
Fraumeni, JF
中科院分区：
文献类型：
--
作者：
Chow, WH;Devesa, SS;Fraumeni, JF
背景临床调查显示，由于影像学检查的增加，肾细胞癌的偶然检出率正在上升。目的通过年龄、性别、种族和诊断时的肿瘤分期，研究肾细胞癌和肾盂癌的发病率、死亡率和生存趋势，设计计算年龄校正的发病率和死亡率，沿着5年相对生存率，使用来自国家癌症研究所的监测、流行病学和最终结果（SEER）计划的数据。背景和参与者在SEER计划中肿瘤登记所覆盖的9个地理区域中，主要结果测量发病率、死亡率和5年相对生存率，结果1975年至1995年间，白色男性、白色女性、黑人男性和黑人女性的肾细胞癌年龄校正发病率为9.6，分别为4.4、11.1和4.9/10万人年。肾盂癌的相应发病率分别为1.5、0.7、0.8和0.5/10万人-年。肾细胞癌的发病率在1975年至1995年期间稳步上升，白色男性的年发病率为2.3%，白色女性的年发病率为3.1%，黑人男性的年发病率为3.9%，黑人女性的年发病率为4.3%。局部肿瘤的增加最大，但也见于更晚期和未分期的肿瘤。相反，肾盂癌的发病率在白色男性中下降，在白色女性和黑人中保持稳定。虽然5年的相对生存率与肾细胞癌患者改善白人，但不是黑人，肾癌死亡率增加，在所有种族和性别groups.Conclusions增加检测症状前肿瘤的影像学检查，如超声，计算机断层扫描，磁共振成像，并不能完全解释肾细胞癌的发病率上升趋势。其他因素可能导致美国肾细胞癌发病率迅速增加，特别是在黑人中。
Context Clinical surveys have revealed that incidental detection of renal cell carcinoma is rising because of increased use of imaging procedures.Objective To examine incidence, mortality, and survival trends of renal cell and renal pelvis cancers by age, sex, race, and tumor stage at diagnosis,Design Calculation of age-adjusted incidence and mortality rates, along with 5-year relative survival rates, using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program.Setting and Participants Patients diagnosed as having kidney cancer from 1975 through 1995 in the 9 geographic areas covered by tumor registries in the SEER program, which represent about 10% of the US population.Main Outcome Measures Incidence, mortality, and 5-year relative survival rates by time periods,Results The age-adjusted incidence rates for renal cell carcinoma between 1975 and 1995 for white men, white women, black men, and black women were 9.6, 4.4, 11.1, and 4.9 per 100 000 person-years, respectively. The corresponding rates for renal pelvis cancer were 1.5, 0.7, 0.8, and 0.5 per 100 000 person-years, Renal cell cancer incidence rates increased steadily between 1975 and 1995, by 2.3% annually among white men, 3.1% among white women, 3.9% among black men, and 4.3% among black women. Increases were greatest for localized tumors but were also seen for more advanced and unstaged tumors. In contrast, the incidence rates for renal pelvis cancer declined among white men and remained stable among white women and blacks. Although 5-year relative survival rates for patients with renal cell cancer improved among whites but not among blacks, kidney cancer mortality rates increased in all race and sex groups.Conclusions Increasing detection of presymptomatic tumors by imaging procedures, such as ultrasonography, computed tomography, and magnetic resonance imaging, does not fully explain the upward incidence trends of renal cell carcinoma. Other factors may be contributing to the rapidly increasing incidence of renal cell cancer in the United States, particularly among blacks.