Renal Cancer

Renal cancers in adults are classified into two major groups according to the anatomic subsite of origin. The predominant group, originating from the renal parenchyma, is mostly renal cell carcinoma, which, in turn, is further classified into morphologically, clinically, and genetically distinct subtypes. Over 75% of renal cell carcinomas are designated clear cell, which is closely linked to alterations in the VHL gene. Almost all cancers arising from the renal pelvis and ureter are urothelial carcinomas, previously known as transitional cell carcinomas. Renal cell cancer incidence rates have increased globally over the past few decades. In the United States, incidence rates among blacks have surpassed rates for whites. Modifiable risk factors such as cigarette smoking, obesity, and hypertension, are more common among blacks than whites, partly explaining the racial disparity in renal cell cancer incidence. Having a first-degree relative with kidney cancer also has been linked to a two- to five-fold elevated risk.