Miki Haifler1, Amos Neheman2, Amnon Zisman2. 1. Department of Urology, Shamir Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: mikihaifler@gmail.com. 2. Department of Urology, Shamir Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: Both population-based databases and institutional cohorts demonstrated downward stage migration in renal cancer incidence, paralleling an increased use of cross-sectional imaging. More than 3 decades have passed since the introduction of cross-sectional imaging. Therefore, the trend toward lower stage renal cancer may have reached its full potential. We aimed to examine renal cancer incidence, survival, and mortality trends. PATIENTS AND METHODS: Examining the Surveillance, Epidemiology, and End Results (SEER) database, data on renal cancer patients older than 20 years were extracted. We calculated age-adjusted incidence, mortality rates, and 5-year cancer-specific survival between 2000 and 2016. Trends were quantified with the annual percentage change (APC) and analyzed by joinpoint analysis according to disease stage. RESULTS: The incidence APC of localized, regional, and distant stage was +2.7% per year, +0.6% per year, and -0.4% per year, respectively. There was a significant decrease in APC for localized disease in 2008. The APC in 5-year cancer-specific survival rates of localized, regional, and distant disease were 0.28%, 1.03%, year and 0.43% per year, respectively, with no joinpoint identified. The overall age-adjusted mortality increased by 5.8% per year. For localized disease, mortality APC sequentially decreased from 80.1% per year before 2002 to 15.9% per year between 2002 and 2009, and to 6% per year after 2009. The mortality APC of regional and distant disease changed in 2002 from 74.2% per year to 3.8% per year, and from 31.1% per year to -0.3% per year (P < .001 for both), respectively. CONCLUSION: The upward trend of renal cancer incidence has been curbed, probably as a result of the use of cross-sectional imaging reaching its potential as a pseudo-screening tool. Localized disease mortality rates continued to increase at a decreasing rate.
BACKGROUND: Both population-based databases and institutional cohorts demonstrated downward stage migration in renal cancer incidence, paralleling an increased use of cross-sectional imaging. More than 3 decades have passed since the introduction of cross-sectional imaging. Therefore, the trend toward lower stage renal cancer may have reached its full potential. We aimed to examine renal cancer incidence, survival, and mortality trends. PATIENTS AND METHODS: Examining the Surveillance, Epidemiology, and End Results (SEER) database, data on renal cancerpatients older than 20 years were extracted. We calculated age-adjusted incidence, mortality rates, and 5-year cancer-specific survival between 2000 and 2016. Trends were quantified with the annual percentage change (APC) and analyzed by joinpoint analysis according to disease stage. RESULTS: The incidence APC of localized, regional, and distant stage was +2.7% per year, +0.6% per year, and -0.4% per year, respectively. There was a significant decrease in APC for localized disease in 2008. The APC in 5-year cancer-specific survival rates of localized, regional, and distant disease were 0.28%, 1.03%, year and 0.43% per year, respectively, with no joinpoint identified. The overall age-adjusted mortality increased by 5.8% per year. For localized disease, mortality APC sequentially decreased from 80.1% per year before 2002 to 15.9% per year between 2002 and 2009, and to 6% per year after 2009. The mortality APC of regional and distant disease changed in 2002 from 74.2% per year to 3.8% per year, and from 31.1% per year to -0.3% per year (P < .001 for both), respectively. CONCLUSION: The upward trend of renal cancer incidence has been curbed, probably as a result of the use of cross-sectional imaging reaching its potential as a pseudo-screening tool. Localized disease mortality rates continued to increase at a decreasing rate.