Less overdiagnosis of kidney cancer? an age‐period‐cohort analysis of incidence trends in 16 populations worldwide

Abstract

The increasing rates of kidney cancer incidence, reported in many populations globally, have been attributed both to increasing exposures to environmental risk factors, as well as increasing levels of incidental diagnosis due to widespread use of imaging. To better understand these trends, we examine long-term cancer registry data worldwide, focusing on the roles of birth cohort and calendar period, proxies for changes in risk factor prevalence and detection practice respectively. We used an augmented version of the Cancer Incidence in Five Continents series to analyze kidney cancer incidence rates 1978-2007 in 16 geographically representative populations worldwide by sex for ages 30-74, using age-period-cohort (APC) analysis. The full APC model provided the best fit to the data in most studied populations. While kidney cancer incidence rates have been increasing in successive generations born from the early twentieth century in most countries, equivalent period-specific rises were observed from the late-1970s, although these have subsequently stabilized in certain European countries (the Czech Republic, Lithuania, Finland, Spain) as well as Japan from the mid-1990s, and from the mid-2000s, in Colombia, Costa Rica and Australia. Our results indicate that the effects of both birth cohort and calendar period contribute to the international kidney cancer incidence trends. While cohort-specific increases may partly reflect the rising trends in obesity prevalence and the need for more effective primary prevention policies, the attenuations in period-specific increases (observed in 8 of the 16 populations) highlight a possible change in imaging practices that could lead to mitigation of overdiagnosis and overtreatment.

Profiling global cancer incidence and mortality by socioeconomic development

“…Over-detection practices, which become more prevalent as socioeconomic development grows, and under-diagnosis and under-reporting in countries with lower socioeconomic level, may also partly explain why incidence but not mortality rates increase together with socioeconomic development. [24][25][26][27][28] The rise in cancer incidence among Group B cancers across EdI is predominantly driven by lung cancer and explained by the earlier adoption and high prevalence of tobacco smoking in high EdI countries. 29 Lung, brain and pancreatic cancers still have limited early detection and treatment options, which may explain the similarity of the patterns between incidence and mortality rates.…”

Primary epidemiological evaluation of the effectiveness of the All-National Dispensarization as a cancer screening by the data of the Arkhangelsk Regional Cancer Registry

“…Значительное число случаев рака почки являются медленно прогрессирующими, поэтому зарегистрированный в нашем исследовании результат необязательно может привести к снижению смертности и увеличению выживаемости, необходим дополнительный анализ. Подобный эффект зарегистрирован и в других странах [42].…”

“…Наконец, даже увеличение доли I стадии рака в скрининговой программе далеко не всегда приводит к снижению смертности из-за эффекта гипердиагностики -выявления несмертельных медленно прогрессирующих форм рака, лечение которых может быть связано даже с большим риском смерти, чем просто наблюдение. Эффект гипердиагностики описан при скрининге рака предстательной железы, молочной железы, щитовидной железы, почки [42,[45][46][47]. По этой причине необходим дополнительный анализ смертности и выживаемости при ЗНО, при которых в данном анализе был зарегистрирован этот эффект.…”

Dietary Patterns in Italy and the Risk of Renal Cell Carcinoma

“…Incidence rates have been also reported to increase in the world since the 70s, with an average annual percentage increase between 2% and 3% [4]. Modifications of lifestyle and exposures to risk factors, aa well as in tumor detection and diagnostic procedures over time, are hypothesized to account for these temporal trends [5]. Furthermore, kidney cancer is one of the few neoplasms with an unfavorable trend in mortality over recent decades [6].…”