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Kidney Cancer in Canada

Kidney cancer is among the most common cancers worldwide. The likelihood of getting it depends on the stage (how large it is and whether it has spread) when you are diagnosed, as well as the type of kidney cancer you have.

In previous studies of observation in previous studies, the rates of KCa were twice as high in Indigenous Canadians when age-standardized. There isn't much studies on the experiences of patients with KCa.

Background

In 2017, Canada saw an estimated 6600 cases of kidney cancer as well as 1900 deaths. Established risk factors include male sex, Canadian Pacific Kidney Cancer age over 60, relatives with a history of kidney cancer smoking, diabetes mellitus, high blood pressure and obesity2.

To estimate global incidence and mortality for this disease, GBD incorporates data from important registration systems and cancer registry data to build a cause-of-death ensemble model. This model employs a linear step mix-effects model to link the data collected with several covariates, including demographic characteristics, healthcare access and quality, as well as socioeconomic and geographic context.

The model then multiplies incident cases by independently modeled mortality-to-incidence ratios to obtain age-adjusted rates for all countries. Kidney cancer is 10th most common cancer type worldwide. Its mortality rate is higher than that of other major neoplasms. It is responsible for more than 3.3 million DALYs lost globally in 20172.

All 195 countries are included. They are categorized by age, gender and according to the Socio-Demographic Index (SDI).

Recent studies have demonstrated that the incidence of rccc in non-Indigenous Canadians is twice as high. These differences may be related to differences in risk factor prevalence or to different patterns of tumour occurrence in these populations. This study compares outcomes and presentation of rccc among Indigenous and non-Indigenous Canadas using data from a national cohort.

Methods

In Canada the most frequent kind of kidney cancer is renal cell carcinoma (rcc). RCC is treated with chemotherapy drugs that target the tumor cells and impede the spread or growth of cancer. Other treatment options include surgical procedures and other treatments, such as cryoablation and radiofrequency ablation.

The outlook for a patient's life is contingent on the stage (how large the tumor is) and the grade of their cancer. The lower the grade the better the chance of survival. The stage of cancer determines if it has developed beyond the kidneys which will determine the treatment option that is best for you.

Treatment decisions are based on the patient's preferences and goals as well as their health history. This includes other diseases and conditions, for example high blood pressure as well as heart disease, diabetes and diabetes. Patients should be encouraged to speak with their doctor about their treatment options, so they can make the decision that is right for them. This is referred to as shared decision-making and it can enhance outcomes for patients.

This study was designed with the goal of improving the quality of care for patients in this group. It examined KCa patients' experiences with their access to healthcare and their understanding of the treatment options. The survey was mailed to KCC members as well as Urology clinics across Canada with the help of KCC's Medical Advisory Board, who provided input on questionnaire wording.

Results

The incidence of rcc was higher in the Indigenous canadian pacific scleroderma cohort than in the non-Indigenous canadian pacific leukemia population, but the difference was not statistically significant (p = 0.36). The majority of patients (68%) had cT1-staged disease at the time of their clinical diagnosis. There were no indications of metastases. Renal surgery was performed on 81 percent of Indigenous Canadians, and 75% of non Indigenous Canadians with 55% of them having radical nephrectomy.

LDHA expression was significantly lower in the samples of biopsy from the Indigenous canadian Pacific kidney cancer cohort compared to the non-Indigenous canadian pacific esophageal cancer cohort. This finding is in line with the role played by the ldha gene in rcc as a tumour suppressor gene. It may also cause a higher incidence of rcc within the Indigenous population.

The rates of the biopsy were similar in both groups. In both groups, a median interval of 2.4 months was observed between the clinical diagnosis and the renal mass biopsy. The majority of the 134 kidney masses biopsied were ccRCC (75 percent) and papillary cancer in 10 percent and chromophobe renal cells carcinoma in nine.

In 2017, kidney cancer caused 138.5 thousand deaths (95% UI : 128.7-142.5). The average age-standardised mortality rate for kidney cancer in 2017 was 4.9 (95 percent of UI: 4.7-5.1). This was significantly lower than the average global age-standardised mortality of 1.7 (95 percent U.S. UI: 1.6-1.8) for all other cancers combined.

Conclusions

Kidney cancer is the 10th most commonly diagnosed type of cancer in the world, with approximately 6600 new diagnoses and 1900 deaths in Canada in 2017. The majority of cases are renal cell carcinoma (rcc) an endocrine tumor which develops in kidney cells. Other types include transitional cells, Wilms tumor, and renal sarcomas. Some rare genetic conditions like Von Hippel-Lindau Disease, Sickle Cell Disease and Tuberous Sclerosis Complex increase the risk of developing kidney cancer.

The etiology of the majority of kidney cancers is not known, and it is believed to be multifactorial. Certain risk factors identified have a modifiable. Indigenous Canadians are reported to have higher rates of rcc than non-Indigenous Canadians. But, little is known about the difference in rccc presentation and treatment among current Indigenous patients.

To better understand the obstacles faced by KCa patients to receiving quality healthcare, KCC conducted a patient-centered experience of care survey with KCa patients in Canada. The results from this first-of-its-kind patient-led study offer important information about the quality of care as well as the unique perspectives of KCa patients on their experiences with their healthcare providers. KCC hopes to utilize this information to improve access to care for patients from Canada and improve their outcomes. Most participants reported having excellent or good access to their healthcare providers. People living in the Eastern region and Quebec, as well as those from rural or suburban areas were less likely have access to experts from the RCCS or treatment options.