Chapter 4: Cancer incidence in Canada: trends and projections (1983-2032) – Kidney cancer - HPCDP: Volume 35, Supplement 1, Spring 2015

Chapter 4: Projections by Cancer Site

16. Kidney cancer

Kidney cancer was the sixth most common type of new cancer diagnosed in Canadian males and the twelfth most common type in females in 2003–2007. The average annual number of kidney cancer cases in this period was 2580 for males and 1665 for females, accounting for 3.2% and 2.2% of all male and female cases, respectively (Tables 4.16.1 and 4.16.2).

TABLE 4.16.1
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), cancer of kidney, males, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 200 20 20 5 10 80 50 5 10 0 5 0
45–54 435 35 45 10 20 165 115 15 20 5 5 0
55–64 690 70 65 20 25 250 190 25 30 5 15 0
65–74 650 70 60 25 35 210 185 25 30 5 10 0
75–84 475 50 45 20 25 155 140 15 20 0 5 0
85+ 125 20 15 5 5 35 35 5 5 0 0 0
Total 2580 260 245 85 120 895 715 90 110 15 45 0
2008–12 <45 215 15 20 5 10 95 50 5 10 0 5 0
45–54 495 40 55 15 25 190 125 15 20 5 10 0
55–64 835 80 80 20 30 295 230 35 35 5 20 0
65–74 790 80 80 25 30 260 220 30 35 5 15 0
75–84 550 60 50 20 30 175 170 15 20 5 10 0
85+ 170 20 20 5 10 50 55 5 5 0 0 0
Total 3050 295 305 90 130 1070 845 110 130 20 55 5
2013–17 <45 225 15 25 5 10 100 55 5 10 0 0 0
45–54 510 40 50 10 20 215 125 15 20 5 10 0
55–64 950 85 100 25 35 355 245 40 35 5 20 0
65–74 1015 100 100 30 40 330 285 45 50 5 20 0
75–84 610 65 60 20 30 195 185 20 25 5 10 0
85+ 220 25 25 5 10 70 70 5 5 0 0 0
Total 3535 335 365 100 145 1260 960 130 145 25 60 5
2018–22 <45 235 15 25 5 10 105 60 5 10 0 0 0
45–54 505 35 55 10 20 225 115 15 20 5 10 0
55–64 1065 95 110 30 40 415 265 40 40 5 20 0
65–74 1225 120 130 35 45 400 335 55 55 10 25 0
75–84 755 75 80 25 30 240 225 25 35 5 10 0
85+ 260 30 30 5 10 80 85 5 10 0 0 0
Total 4040 375 425 110 155 1465 1085 150 165 25 70 5
2023–27 <45 220 15 20 5 10 105 55 5 10 0 0 0
45–54 535 35 55 10 20 235 125 15 20 5 5 0
55–64 1085 95 105 25 35 455 260 40 40 5 20 0
65–74 1405 135 170 45 50 480 360 60 55 10 30 0
75–84 995 95 105 25 40 310 300 40 50 5 15 0
85+ 300 35 40 5 10 95 95 10 10 0 0 0
Total 4545 415 490 120 170 1680 1200 170 185 30 75 5
2028–32 <45 215 15 15 5 10 100 50 5 10 0 0 0
45–54 555 35 55 15 25 250 140 15 20 5 5 0
55–64 1070 85 105 20 35 470 240 40 35 5 15 0
65–74 1575 155 185 45 55 560 400 65 65 10 30 0
75–84 1210 120 135 35 45 385 350 50 55 10 20 0
85+ 395 45 50 10 15 120 125 10 15 0 0 0
Total 5020 455 550 125 180 1885 1305 185 200 35 75 5
TABLE 4.16.2
Observed (2003–2007) and projected average annual new cases by age and province/territories combined (TC), cancer of kidney, females, Canada, 2003–2032
Period Age New cases
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

Note: Totals may not add up due to rounding.

2003–07 <45 140 10 15 5 5 60 35 5 5 0 0 0
45–54 235 20 25 5 10 90 60 10 10 0 5 0
55–64 360 30 30 10 15 130 100 15 20 0 5 0
65–74 405 40 35 10 15 150 110 15 20 5 5 0
75–84 380 35 30 15 20 135 115 10 15 0 5 0
85+ 150 15 10 5 5 50 50 5 5 0 0 0
Total 1665 150 145 55 70 615 465 55 75 10 25 5
2008–12 <45 140 10 15 5 5 65 35 5 5 0 0 0
45–54 270 20 25 10 15 105 70 10 10 0 5 0
55–64 440 35 35 15 15 170 120 20 20 0 10 0
65–74 465 45 40 10 20 175 125 15 25 0 10 0
75–84 415 35 30 15 20 145 125 15 20 0 5 0
85+ 195 20 15 5 10 70 60 5 5 0 0 0
Total 1935 170 165 60 75 725 535 65 85 10 30 5
2013–17 <45 155 10 20 5 5 80 35 5 5 0 0 0
45–54 270 15 25 10 15 110 70 10 10 0 5 0
55–64 515 40 40 15 20 195 135 20 25 0 10 0
65–74 580 55 45 15 20 215 155 20 30 5 10 0
75–84 460 40 35 10 20 165 135 15 20 0 5 0
85+ 245 25 20 5 10 85 80 5 10 0 0 0
Total 2220 185 185 65 85 850 615 75 100 10 35 5
2018–22 <45 160 10 20 5 5 90 35 5 5 0 0 0
45–54 260 15 25 10 10 110 65 10 10 0 5 0
55–64 560 40 45 20 25 215 155 20 25 5 10 0
65–74 715 65 55 20 25 275 185 25 35 5 15 0
75–84 535 50 40 10 20 190 160 20 25 0 5 0
85+ 275 25 20 5 10 95 90 10 10 0 0 0
Total 2505 205 210 70 95 980 685 85 110 10 40 5
2023–27 <45 170 10 25 5 5 100 35 5 5 0 0 0
45–54 270 15 25 10 10 130 60 10 10 0 5 0
55–64 545 35 45 20 25 210 150 20 25 0 10 0
65–74 820 70 60 25 30 315 210 30 40 5 15 0
75–84 675 60 50 15 25 235 205 25 35 5 10 0
85+ 315 30 25 5 10 115 100 10 10 0 0 0
Total 2795 225 230 75 105 1105 755 95 125 15 45 5
2028–32 <45 160 10 20 5 5 100 30 5 5 0 0 0
45–54 290 15 30 10 15 150 60 10 10 0 5 0
55–64 525 35 45 15 20 215 135 20 20 0 10 0
65–74 895 75 70 30 35 340 230 35 45 5 15 0
75–84 825 70 60 20 30 300 240 30 40 5 10 0
85+ 370 40 30 5 10 130 120 10 15 0 0 0
Total 3070 245 250 85 120 1235 810 105 135 15 45 5

One in 56 males and 1 in 82 females can expect to be diagnosed with kidney cancer in their lifetime, and 1 in 149 males and 1 in 252 females can expect to die from it.Endnote 1 The 5-year relative survival rate for kidney cancer was 68% for both sexes combined in Canada between 2006 and 2008.Endnote 1

During 2003–2007, the ASIRs of kidney cancer increased with age to 83.1 per 100 000 in men and 43.4 per 100 000 in women for those aged 85 or older, but for those aged 55 or older the increase was less pronounced in women than in men (Tables 4.16.3 and 4.16.4).

TABLE 4.16.3
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), cancer of kidney, males, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 1.9 1.4 1.7 1.8 2.1 1.9 2.0 2.4 2.7 2.6 2.1 0.0
45–54 17.6 10.5 17.9 16.2 23.1 17.7 18.5 27.7 24.5 26.9 16.7 10.0
55–64 40.4 29.2 41.9 38.3 43.3 39.1 43.7 54.8 53.1 58.0 49.5 20.2
65–74 60.8 45.5 68.5 67.6 91.9 52.2 68.7 87.1 81.9 93.8 66.0 36.0
75–84 76.3 56.3 86.2 88.4 93.3 64.0 96.1 94.8 105.9 58.9 69.1 28.8
85+ 83.1 76.1 97.4 66.5 102.9 63.0 116.7 87.4 104.4 132.8 26.8 0.0
Total 14.4 10.5 15.5 14.7 18.3 13.1 16.4 19.6 19.5 19.6 14.8 6.3
2008–12 <45 2.1 1.1 1.8 1.8 2.3 2.4 2.2 2.4 3.4 2.7 1.8 0.9
45–54 18.1 11.3 18.4 17.7 24.2 18.1 19.2 26.4 24.5 30.4 20.0 8.1
55–64 40.4 27.7 38.7 36.8 44.3 38.7 45.0 70.3 56.0 61.5 46.5 18.0
65–74 63.5 45.9 75.6 72.5 77.5 56.0 70.3 92.8 90.3 93.1 75.7 28.3
75–84 79.3 58.4 87.8 82.1 113.6 65.2 100.2 99.5 103.3 100.6 71.6 35.3
85+ 81.2 61.6 109.6 60.4 101.1 61.6 118.9 89.3 105.9 115.6 30.8 36.2
Total 14.9 10.2 16.0 14.8 18.4 13.7 17.0 21.4 20.8 21.6 15.5 6.6
2013–17 <45 2.2 1.1 1.7 1.9 2.3 2.4 2.3 2.5 3.5 2.8 1.8 1.0
45–54 18.8 10.8 17.8 16.4 24.0 20.0 20.0 29.1 26.7 31.8 20.5 8.4
55–64 40.3 26.9 41.2 39.1 43.4 39.7 43.0 69.6 50.3 63.9 47.9 18.0
65–74 65.1 45.6 73.6 68.1 75.9 56.6 73.6 110.8 101.7 96.5 77.8 29.0
75–84 79.8 55.6 94.6 89.8 108.4 66.5 99.2 99.3 104.9 104.2 73.6 35.5
85+ 81.6 65.7 104.8 63.6 92.6 64.4 113.4 93.9 102.8 119.6 31.8 36.4
Total 15.1 10.0 16.1 14.9 17.9 14.2 17.2 22.9 21.3 22.4 15.9 6.7
2018–22 <45 2.1 1.0 1.6 1.9 2.4 2.5 2.4 2.5 3.5 2.9 1.8 0.9
45–54 20.0 10.0 18.4 16.9 24.4 22.3 20.4 29.9 28.8 32.7 20.8 8.9
55–64 40.8 27.2 40.5 37.9 44.3 40.7 43.8 70.9 51.8 65.6 48.8 18.2
65–74 64.7 44.6 72.8 66.4 71.1 56.8 73.5 118.2 95.3 98.8 79.2 28.8
75–84 81.5 55.7 98.9 90.6 99.6 68.5 98.6 110.2 118.1 106.6 75.0 36.3
85+ 82.0 64.6 107.2 61.5 103.4 62.8 115.7 97.0 98.5 122.4 32.5 36.6
Total 15.3 9.8 16.2 14.8 17.5 14.6 17.3 24.1 21.7 23.0 16.1 6.8
2023–27 <45 1.9 0.9 1.4 1.9 2.4 2.2 2.2 2.5 3.5 2.9 1.8 0.8
45–54 21.2 10.1 18.5 17.2 24.6 23.5 22.1 30.4 28.9 33.2 20.9 9.4
55–64 41.9 26.6 39.0 34.4 43.3 44.0 44.9 74.9 55.4 66.5 49.3 18.7
65–74 64.4 43.1 76.7 68.6 69.9 58.0 70.2 113.8 87.3 100.0 79.9 28.7
75–84 82.7 54.9 95.3 82.9 96.4 68.6 102.7 127.6 130.6 107.9 75.7 36.9
85+ 82.0 60.6 117.7 69.7 87.3 65.3 111.3 92.1 103.1 123.8 32.8 36.5
Total 15.4 9.6 16.1 14.5 17.1 14.9 17.4 24.7 22.0 23.3 16.3 6.9
2028–32 <45 1.8 1.0 1.2 2.0 2.4 2.0 2.0 2.6 3.5 2.9 1.8 0.8
45–54 20.5 8.4 17.6 17.5 24.8 23.5 23.4 30.9 29.1 33.7 21.1 9.2
55–64 44.0 24.7 40.2 34.9 43.6 48.1 45.4 75.9 58.8 67.3 49.8 19.6
65–74 65.0 44.3 74.3 64.2 69.9 59.0 71.5 116.5 89.4 101.1 80.6 29.0
75–84 81.9 54.2 95.0 81.1 89.5 68.7 100.7 133.0 120.4 109.2 76.4 36.5
85+ 84.4 63.4 119.0 65.3 83.8 66.6 112.2 108.9 121.0 125.2 33.2 37.6
Total 15.5 9.3 15.9 14.2 16.9 15.3 17.4 25.4 22.3 23.5 16.4 6.9
TABLE 4.16.4
Observed (2003–2007) and projected age-standardized incidence rates (ASIRs) by age and province/territories combined (TC), cancer of kidney, females, Canada, 2003–2032
Period Age ASIRs
CA BC AB SK MB ON QC NB NS PE NL TC

Abbreviations: AB, Alberta; BC, British Columbia; CA, Canada; MB, Manitoba; NB, New Brunswick; NL, Newfoundland and Labrador; NS, Nova Scotia; ON, Ontario; PE, Prince Edward Island; QC, Quebec; SK, Saskatchewan; TC, All Territories (Yukon, Northwest Territories and Nunavut).

2003–07 <45 1.4 0.7 1.5 1.3 1.4 1.5 1.4 1.8 1.8 1.9 1.4 1.5
45–54 9.4 5.5 9.5 10.0 12.7 9.6 9.4 15.4 13.4 5.5 12.7 2.9
55–64 20.4 13.5 20.6 23.8 21.3 19.6 21.9 27.4 33.1 26.9 23.0 20.4
65–74 33.9 24.6 37.2 28.3 37.1 32.7 35.7 55.3 48.8 47.0 26.7 68.2
75–84 43.6 30.2 42.8 52.1 52.4 40.3 52.2 43.6 55.6 44.3 45.8 0.0
85+ 43.4 32.0 43.8 37.0 41.2 38.1 60.2 50.3 49.5 32.2 19.6 0.0
Total 8.0 5.3 8.3 8.2 9.0 7.8 8.8 11.1 11.4 9.3 8.0 7.7
2008–12 <45 1.4 0.7 1.5 1.3 1.4 1.6 1.5 1.6 1.4 1.4 1.4 1.4
45–54 9.9 4.9 9.2 12.7 14.1 10.1 10.8 14.3 14.9 10.0 12.7 8.4
55–64 20.6 11.9 18.7 22.3 20.5 20.9 22.6 32.3 29.8 20.9 23.3 22.0
65–74 34.5 24.7 35.0 29.2 40.6 33.7 35.7 51.0 52.2 34.8 36.7 35.1
75–84 45.6 30.6 44.3 44.8 52.5 41.3 54.4 58.8 70.0 44.7 36.2 30.0
85+ 45.3 36.7 47.9 34.2 41.4 41.1 58.8 48.2 50.9 45.4 18.7 24.1
Total 8.3 5.2 8.1 8.1 9.3 8.2 9.2 11.5 11.7 8.3 8.4 7.5
2013–17 <45 1.5 0.8 1.7 1.3 1.4 1.9 1.5 1.6 1.4 1.5 1.4 1.6
45–54 9.9 4.1 8.8 12.1 14.3 9.9 11.6 14.7 15.4 10.2 12.9 8.4
55–64 21.1 11.5 17.1 22.4 23.6 21.4 23.3 35.3 31.6 21.5 24.1 20.6
65–74 34.4 23.1 31.7 35.1 37.3 33.9 36.6 48.4 53.9 35.6 37.9 33.6
75–84 47.5 31.0 45.6 36.7 54.3 43.9 56.4 67.4 71.3 45.7 37.3 32.0
85+ 48.1 34.4 44.1 39.0 49.2 43.5 63.2 53.7 58.2 46.5 19.4 26.3
Total 8.5 5.0 7.8 8.2 9.6 8.6 9.4 12.0 12.1 8.5 8.6 7.5
2018–22 <45 1.5 0.7 1.7 1.3 1.4 2.1 1.4 1.6 1.4 1.5 1.4 1.8
45–54 10.3 4.3 8.7 11.7 14.4 10.9 11.6 14.9 15.7 10.3 13.1 8.6
55–64 21.2 10.7 17.6 25.6 26.7 20.7 25.0 34.8 31.8 21.7 24.7 19.9
65–74 34.9 21.8 29.8 35.5 35.4 35.5 37.0 51.9 54.7 36.0 38.7 31.0
75–84 47.7 31.2 42.5 37.6 57.2 44.1 56.7 67.5 76.3 46.2 38.1 32.6
85+ 48.6 35.4 46.2 34.3 41.6 44.8 62.0 64.5 61.5 46.9 19.8 28.7
Total 8.6 4.8 7.6 8.5 9.7 8.9 9.6 12.4 12.5 8.6 8.7 7.4
2023–27 <45 1.5 0.8 1.7 1.3 1.4 2.2 1.4 1.6 1.4 1.5 1.4 2.0
45–54 10.5 4.2 8.6 11.5 14.4 12.5 10.7 15.0 15.8 10.4 13.2 9.2
55–64 20.9 9.3 17.0 25.2 26.8 20.0 26.0 35.1 32.1 21.8 25.0 19.7
65–74 35.2 21.2 27.4 37.8 39.9 35.3 37.8 55.1 56.7 36.2 39.1 28.7
75–84 47.2 29.2 38.7 46.0 52.4 43.6 57.4 63.6 76.3 46.5 38.5 31.3
85+ 50.7 36.0 46.7 27.3 50.2 47.2 65.3 70.7 60.1 47.3 20.1 30.2
Total 8.6 4.7 7.3 8.8 10.0 9.0 9.6 12.5 12.6 8.7 8.8 7.5
2028–32 <45 1.4 0.7 1.6 1.3 1.4 2.1 1.3 1.6 1.4 1.5 1.4 2.3
45–54 10.7 3.9 9.6 11.3 14.5 13.9 10.1 15.1 16.0 10.4 13.3 10.1
55–64 21.5 9.8 16.6 24.8 26.9 21.3 25.8 35.3 32.3 21.8 25.2 20.3
65–74 35.1 20.1 27.9 42.3 44.4 33.9 39.7 54.2 56.6 36.2 39.5 27.5
75–84 47.5 28.1 36.4 45.3 50.1 45.3 57.1 68.6 77.8 46.5 39.0 28.8
85+ 49.1 36.2 41.1 33.6 47.6 45.1 62.7 65.8 67.4 47.4 20.3 30.0
Total 8.6 4.5 7.2 9.1 10.2 9.2 9.6 12.6 12.8 8.7 8.9 7.7

Overall, kidney cancer incidence occurred nearly twice as often in males as in females. The male-to-female ratio increased with age in each observation period up to the 65–74 age group and stabilized at almost 2:1 in older age groups (Figure 4.16.2). Tables 4.16.1 and 4.16.2 show that about 90% of cases were diagnosed in people aged 45 or older in 2003–2007.

Figure 4.16.1 shows that incidence rates generally increased in both sexes during the 1980s, stabilized between 1988–1992 and 1993–1997, and rose again after that. In 2003–2007, kidney cancer ASIRs in males increased significantly by 2.6% per year (a change point in trend was detected from 2003, Figure 3.1). During 1998–2007, ASIRs rose significantly in females by 1.9% per year (Figure 3.2). Figure 4.16.2 reveals that incidence of kidney cancer increased over the observation periods across age groups in both sexes, with stronger increases in males in the 1980s and in those (except in the 75–84 age group) during the last 2 observation periods.

FIGURE 4.16.1
Age-standardized incidence rates (ASIRs) by region, kidney cancer, 1983–2032

Age-standardized incidence rates (ASIRs) by region, kidney cancer, 1983–2032

[Click to enlarge]

[FIGURE 4.16.1, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.16.1
Age-standardized incidence rates (ASIRs) by region, kidney cancer, 1983-2032

Figure 4.16.1 shows that the observed incidence rates of kidney cancer in Canada generally increased in both sexes during the 1980s, stabilized between 1988-1992 and 1993-1997, and rose again after that. The rates are projected to increase in both sexes in all regions except in British Columbia, where a gradual decrease is predicted, and in the Prairies in females, for whom the rates are forecast to stabilize. The most elevated rates are predicted for the Atlantic region, while significantly low rates are predicted in British Columbia.

The current rising trends in the rates in Canada are projected to continue in each age group (Figure 4.16.2). Figure 4.16.1 shows that the rates of kidney cancer will increase in both sexes in all regions except in British Columbia, where a gradual decrease is predicted, and in the Prairies in females, for whom the rates are forecast to stabilize.

FIGURE 4.16.2
Age-standardized incidence rates (ASIRs) for kidney cancer by age group, Canada, 1983–2032 (red lines denote males, blue lines denote females)

Age-standardized incidence rates (ASIRs) for kidney cancer by age group (males, females), Canada, 1983–2032

[Click to enlarge]

[FIGURE 4.16.2, Text Equivalent]

Health Promotion and Chronic Disease Prevention in Canada - Volume 35 · Supplement 1 · Spring 2015

FIGURE 4.16.2
Age-standardized incidence rates (ASIRs) for kidney cancer by age group, Canada, 1983-2032

Kidney cancer is more common in males than in females in each age group. The male-to-female ratio increased with age in each observation period up to the 65-74 age group and stabilized at almost 2:1 in older age groups. Incidence of kidney cancer increased over the observation periods across age groups in both sexes, with stronger increases in males in the 1980s and in those (except in the 75-84 age group) during the last 2 observation periods. The rates are projected to rise in each age group, but the longer-term trend shows a downturn in males younger than 45.

The most elevated rates are predicted for the Atlantic region, while significantly low rates are predicted in British Columbia.

From 2003–2007 to 2028–2032, the ASIRs of kidney cancer for Canada are projected to increase by roughly 7% in both sexes, from 14.4 to 15.5 per 100 000 in males and from 8.0 to 8.6 per 100 000 in females (Tables 4.16.3 and 4.16.4). The annual number of new cases is estimated to increase by 95% in males, from 2580 to 5020, and by 84% in females, from 1665 to 3070 (Tables 4.16.1 and 4.16.2).

Comments

Increases in kidney cancer incidence have been observed in the US, some European countries, Australia, New Zealand and some Asian countries.Endnote 224, Endnote 225, Endnote 226, Endnote 227, Endnote 228, Endnote 229, Endnote 230 Although the increasing use of advanced diagnostic imaging systems has probably led to the incidental detection of asymptomatic kidney cancer,Endnote 231 the incidence of cancer presenting at a later stage has not decreased.Endnote 232 This finding suggests that a true increase in kidney cancer has occurred that cannot be solely attributed to changes in diagnostic practices.Endnote 225

The upward trend in kidney cancer in Canada may be partly explained by changes in risk factors. The major risk factors for kidney cancer include smoking, obesity and some genetic and medical conditions. Smokers have a 50% increase in risk.86 Cigarette smoking is responsible for about 20% to 30% of kidney cancer cases inmales and 10% to 24% of cases in females.Endnote 111, Endnote 233, Endnote 234, Endnote 235 Smoking prevalence began to decrease in the mid-1960s in males and in the mid-1980s in females.Endnote 42, Endnote 43 Smoking prior to these periods may have contributed to the earlier increases in kidney cancer rates around and immediately following these periods. The reductions in smoking are expected to curb the increase in kidney cancer incidence in the future.

Obesity is a significant risk factor for both sexes, and is responsible for about 20% of renal cell carcinoma cases, the predominant form of kidney cancer.Endnote 233, Endnote 235 The prevalence rates of obesity have nearly doubled in adults from 1978/79 to 2012.Endnote 51, Endnote 72, Endnote 73 The rates of obesity and kidney cancer have been increasing comparably in Canada in recent decades.

Age-standardized smoking rates and overweight or obese rates have been lower in British Columbia than in other provinces. Endnote 51, Endnote 73 This may partly explain the low incidence rates of kidney cancer in British Columbia.

Hypertension has been linked to an excess risk of 20% to 300%,Endnote 233, Endnote 234 with a potential dose-response relationship.Endnote 86 Preventing and controlling hypertension may reduce kidney cancer incidence.Endnote 236 A meta-analysis of 24 studies suggests that diabetes is associated with an increased risk of kidney cancer, and is independent of alcohol use, obesity and smoking.Endnote 237 An increased risk of kidney cancer also has been suggested in patients with acquired renal cystic disease.Endnote 238 Hereditary predispositions, characterized as occurring at birth, are responsible for less than 5% of kidney cancer cases.Endnote 224, Endnote 239 There is sufficient evidence that trichloroethylene (used primarily for metal degreasing, especially in the aerospace/aircraft industry) causes kidney cancer, according to IARC.Endnote 47 The US National Cancer Institute's recent meta-analysis of studies published from 1950 to 2011 indicates a 32% risk increase for occupational trichloroethylene exposure.Endnote 240

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