Renal Cell Carcinoma Epidemiology In The Era Of Widespread Imaging.

e13083 Background: Cancers of the kidney and renal pelvis are the third most commonly diagnosed urological cancers. Renal Cell Carcinoma (RCC) is the most common histological type. The age-standardized rate (ASR) of RCC world-wide is 4.4/100,000 with higher rates in higher income countries. One third of diagnosed RCC patients have metastatic disease at presentation, although recent reports indicate smaller proportions. It has been suggested that the widespread use of imaging performed for various reasons has led to a rise of incidentally diagnosed RCC. We conducted a retrospective analysis of trends in cancers of the kidney and renal pelvis in Israel. Methods: We selected all cases of renal cell carcinoma of the kidney and renal pelvis neoplasms reported to the Israel National Cancer Registry (INCR) for the years 2000-2015. Demographic and clinical variables extracted from the registry included gender, population group, dates of birth/death, tumor size, stage at presentation (according to the Surveillance, Epidemiology and End Results (SEER) summary staging manual 2000). We calculated the overall and population group age-standardized incidence, using the direct method and the Segi World Standard population. Results: A total of 9,595 cases of RCC were identified. The average ASR was 7.7/100,000. RCC incidence was highest in the seventh decade of life with a male/female ratio of 1.7:1. Incidence was higher in the Jewish population than in the Arab population. The proportion of cases with metastatic disease at time of diagnosis was 10%; this figure was unchanged during the study period. Masses smaller than 4 cm. comprised almost two thirds of localized tumors with a significant increase in trend during the period of the study (p < 0.001). Five-year overall survival for localized and metastatic disease was 86% and 12%, respectively. Survival was similar in the Arab and Jewish populations (p = 0.06). Conclusions: RCC incidence and survival in Israel mirror those of other western countries. The proportion of cases with distant spread at diagnosis is smaller than elsewhere reported. Small incidental renal masses (less than 4 cm) are increasingly diagnosed in the localized stages, possibly due to increased using of imaging.