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Kidney Cancer in Canada

Kidney cancer is among the most prevalent cancers in the world. The outlook is based on the stage (how large it is, and if it has spread) when you're diagnosed, and the kind of kidney cancer you suffer from.

Previous observational studies have shown age-standardized rates of incidence twice as high for Indigenous Canadians. There isn't much research on the patient experience with KCa.

Background

In 2017, Canada saw an estimated 6600 cases of kidney cancer and 1900 deaths. Risk factors for kidney cancer are male sex and a age of over 60. Other risk factors are smoking, diabetes, high blood pressure, obesity, and family history.

To estimate global incidence and mortality for this disease, GBD blends data from vital registration systems and cancer registry reports to form a cause-of-death ensemble model. This model makes use of linear step mix-effects technique to link the observed data to a variety of covariates such as the demographic characteristics, health quality and accessibility, as well as geographic and social economic 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 the 10th most frequent kind of cancer in the world and its mortality rate is higher than for the majority of other major neoplasms. It causes more than 3.3 million DALYs lost worldwide in 20172.

All 195 countries are included. They are classified by age, gender and the Socio-Demographic index (SDI).

Previous studies have revealed that the incidence of rccc in non-Indigenous Canadians is twice as high. These differences may be related to differences in risk factors prevalence or canadian pacific esophageal cancer to different patterns of tumour development in these populations. This study compares the outcomes and presentation of rccc in Indigenous and non-Indigenous Canadians based on data from a nationwide cohort.

Methods

The most prevalent form of kidney cancer in Canada is renal cell carcinoma. RCC is treated using chemotherapy drugs that target the tumor cells and impede the spread or growth of the cancer. Other options for treatment include surgical procedures and other treatments, like cryoablation or radiofrequency ablation.

The outlook of a patient depends on both the stage (how large the tumour is) as well as the grade. The better the chance of survival, the lower the grade. The stage of cancer will determine whether it has spread beyond the kidney. This will impact the best treatment for you.

Treatment decisions are based on a patient's goals and preferences as well as the history of their health. This includes other diseases and conditions, for example high blood pressure or diabetes, heart disease and diabetes. Patients should be encouraged to talk with their doctors about their treatment options, so that they can make the right choice that is right for them. This is called shared decision-making and can help to improve the patient experience.

This study was conceived to examine KCa patients' experiences with access to care and knowledge of their treatment options, with the aim to improve the quality of care that is patient-centered for this patient group. The questionnaire was sent to KCC members and urology clinics across Canada with the help of the KCC's Medical Advisory Board, who advised on the questionnaire's language.

Results

The prevalence of rccc was higher in the Indigenous Canadian cohort than in the non-Indigenous canadian pacific esophageal cancer (Https://sites.google.com/) cohort, however, the difference was not statistically significant (p = 0.36). When they were diagnosed, the majority of patients had cT1 stage disease (68%) without evidence of metastases. Renal surgery was carried out in 81% of Indigenous Canadian patients and 75 percent of non-Indigenous Canadians, with 55% of these surgeries being radical nephrectomy.

LDHA was found to be expressed significantly less in the biopsy samples of the Indigenous Canadian cohort compared with the non-Indigenous Canada group. This finding is in line with the significance of LDH in rcc as an tumour suppressor gene. It may also result in a higher incidence of rcc among the Indigenous population.

Biopsy rates were similar across the two groups, with a median times of 2.4 months between diagnosis and the renal mass biopsy in both groups. The majority of 134 kidney masses that were biopsied had ccRCC (75 percent) followed by papillary cancer (10%) and the chromophobe RCC (9).

In 2017, kidney cancer led to 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 UI: 4.7-5.1). This was significantly lower when compared to the global standardised rate of 1.7 (UI: 1.6-1.8).

Conclusions

Kidney cancer is the 10th most commonly diagnosed type of cancer globally, with an estimated 6600 new cases and 1900 deaths in Canada in 2017. Most cases are renal cell carcinoma (rcc), a tumor that develops in kidney cells. Other types include transitional cells, Wilms tumor, and renal Sarcomas. Certain rare genetic disorders such as Von Hippel-Lindau disease Sickle Cell Disease and Tuberous Sclerosis Complex increase risk for developing kidney cancer.

The etiology of the majority of kidney cancers is not known, and it is believed to be multifactorial. However, certain of the risk factors that have been identified could be modified. Indigenous Canadians are reported to have higher rates of rccc compared to non-Indigenous Canadians. There is little information about the different treatment options for rccc and the presentation of Indigenous patients.

KCC conducted an inquiry of KCa patients to better understand the obstacles they face when receiving quality healthcare. The results of this one-of its kind survey by patients provide valuable insight into the unique and high-quality perspectives of KCa patients on their experiences with healthcare providers. KCC hopes to use this valuable data to aid in the improvement of access to care and outcomes for patients in Canada. Results indicate that the majority of participants reported having good or excellent access to their healthcare providers. Patients living in the Eastern region and Quebec and those living in suburban or rural areas were less likely report having access to rcc experts or treatment options.