Moyad M A
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0330, USA.
Semin Urol Oncol. 2001 Nov;19(4):280-93.
Renal cell cancer (RCC) is responsible for a small percentage of total cancer cases and deaths throughout the world, but the incidence rates of RCC have been steadily increasing over the past decade, whereas numerous other cancers have stabilized or even decreased in number. Even in countries that were observed to have a lower incidence of this disease many are now experiencing large increases in the rates of this cancer. Most kidney cancers are RCC, and blacks are currently experiencing RCC rates that are higher than any other race. Older individuals are also at a higher risk compared with young individuals, but this observation may also be changing. The reasons for these potential increases are not understood beyond the partial impact and greater use of newer diagnostic procedures. Other reasons for higher rates of RCC and a better understanding of which individuals may be at the highest risk need to be examined to provide the clinician with possible clues as to who should be tested and what prevention measures should be offered. Most of the past investigations into risk factors have been case-control or retrospective studies, but some generalizations can still be made. Family history and genetics seem to increase risk, but overall are responsible for a small number of the total cases. Smoking, obesity, and even hypertension seem to be risk factors for RCC. Reducing these behaviors and conditions may also reduce the risk of RCC. Healthier eating habits (fruits and vegetables, and a lower caloric intake) and more physical activity may also reduce the risk of RCC. Therefore, it is possible that the increases in RCC may also be due, in part, to unhealthy lifestyle factors that have been on the increase over the past several decades. Recommendations for cardiovascular disease prevention should also be applied to patients or clinicians concerned about RCC risk. Finally, numerous occupations, occupational exposures, reproductive and hormonal changes or manipulations, and a variety of other factors may impact risk, but overall their contribution seems small compared with other more consistent risk factors.
肾细胞癌（RCC）在全球癌症病例和死亡总数中所占比例较小，但在过去十年中，RCC的发病率一直在稳步上升，而许多其他癌症的发病率已趋于稳定甚至下降。即使在那些曾被观察到该病发病率较低的国家，现在许多国家这种癌症的发病率也在大幅上升。大多数肾癌是肾细胞癌，目前黑人的肾细胞癌发病率高于其他任何种族。与年轻人相比，老年人患肾细胞癌的风险也更高，但这种情况可能也在发生变化。除了新诊断程序的部分影响和更多使用之外，这些潜在增长的原因尚不清楚。需要研究肾细胞癌发病率较高的其他原因以及更好地了解哪些人可能处于最高风险，以便为临床医生提供关于哪些人应该接受检测以及应提供哪些预防措施的可能线索。过去对风险因素的大多数调查都是病例对照研究或回顾性研究，但仍可得出一些一般性结论。家族病史和遗传因素似乎会增加风险，但总体上在所有病例中所占比例较小。吸烟、肥胖甚至高血压似乎都是肾细胞癌的风险因素。减少这些行为和状况也可能降低肾细胞癌的风险。更健康的饮食习惯（水果和蔬菜，以及较低的热量摄入）和更多的体育活动也可能降低肾细胞癌的风险。因此，肾细胞癌发病率的上升部分可能也归因于过去几十年中不断增加的不健康生活方式因素。预防心血管疾病的建议也应适用于关注肾细胞癌风险的患者或临床医生。最后，许多职业、职业暴露、生殖和激素变化或操作以及各种其他因素可能会影响风险，但总体而言，与其他更一致的风险因素相比，它们的影响似乎较小。
