Epidemiology of kidney cancer.

Renal-cell carcinoma usually affects those over 40 years old, and, in any age group, the disease occurs about twice as frequently among men as it does among women. The incidence of the disease has been steadily increasing over the years. In the United States, the probability of surviving after diagnosis of renal cancer has been improving since 1940 regardless of race, sex, and age at diagnosis. The relationship between SES and the chance of developing the disease is sporadic with an indication of a slightly higher risk in the upper socioeconomic classes. Urbanrural comparisons consistently suggest that a higher risk is associated with urban residence. Tobacco use is probably the only environmental factor that could be considered to be etiologically related to cancer of the kidney. A variety of studies point to a moderate but consistent association with tobacco use in the form of cigarette, cigar, or pipe smoking. The excess of the disease in males compared to females and the lower incidence in Mormons may partly be due to the confounding effect of smoking. Dietary vitamin A or vitamin A supplements may have an antipromoting effect in the development of kidney cancer. Hypotheses implicating fat and/or cholesterol intake in the etiology of cancer of the kidney appear to be too tenuous. The evidence of a relationship between concentrations of certain trace metals in drinking water and incidence of renal cancer is weak. Similarly, there is no strong indication of an increased risk among individuals exposed to radiation. In general, with the exception of the observation of an unusually high risk among coke-oven workers, occupational studies have not identified any high-risk groups. Familial aggregation, though rare, occurs with peculiar disease characteristics that may predict similar cancers in the proband's relatives with a high degree of accuracy. In conclusion, the etiology of cancer of the kidney is poorly understood. The descriptive epidemiology of the disease provides some interesting insights into the correlates of the distribution of the disease.(ABSTRACT TRUNCATED AT 400 WORDS)