regard to RCC we can only try to identify some clinical and occupational factors as well as substances related to tumorigenesis.
Smoking, chemical carcinogens like asbestos or organic solvents are some of these factors that increase the risk of the RCC. Viralinfections and radiation therapy have also been described as risk factors. Some drugs can increase the incidence of RCC as well as
other neoplasms. Of course, genetics plays an outstanding role in the development of some cases of kidney cancer. Chronic renal
failure, hypertension, and dialysis need to be considered as special situations. Diet, obesity, lifestyle, and habits can also increase
the riskof RCC. The aim of this review is to summarize the well-defined causes of renal cell carcinoma.
Copyright © 2008 D. Pascual and A. Borque. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
Speaking about cancer,one of the most difficult issues is to
find a definite and direct cause. There are few tumors with a
well-known etiology, but renal cell carcinoma (RCC) is not
one of them precisely.
In these cases, we can only try to identify some clinical
and occupational factors, or some substances related to
Epidemiology is an important tool to answer many
questions about cancer origin.Differences in age, gender, and
geographic distribution have been reported, and multiple
clinical factors related to the development of RCC have
been established. Some of them have been thoroughly
demonstrated in experimental models and in vitro studies,
however not all of them recognized as definite etiologic
2. MATERIAL AND METHODS
A systematic review search strategy wasdeveloped to identify
publications related to epidemiology of renal cell carcinoma.
This search strategy was run in PubMed through the medical
subject heading “carcinoma, renal cell” and the subheading
of this descriptor “epidemiology.” We limited our search strategy to articles published in the previous 5 years, language
English or Spanish, and related to humans.
585 articles were found. Abstractswere evaluated and
the full text of articles selected was reviewed. Secondary
search from the bibliography of selected articles was also
The European cancer registry-based study on survival
and care of cancer patients (EUROCARE) and our experience
was considered. Last review was on 31 of March 2008.
3. DEMOGRAPHIC ASPECTS OF
RENAL CELL CARCINOMA
Among urologic tumors, RCCtakes the third place in
incidence, following prostate carcinoma and transitional cell
carcinoma of bladder.
Representing two percent of the adult malignancies ,
this malignancy takes the tenth and fourteenth place among
men and women, respectively, with a man to woman ratio of
3/2 ; see Table 1.
The peak incidence occurs in the sixth decade, with 80%
of the cases within the 40 to69-year-old population.
Although the most frequent renal tumor in the childhood
is the Wilms tumor, it is important to state that the
RCC represents between 2% to 6% of the renal tumors in children, without differences between sexes [3, 4]. Besides,
the incidence of both malignancies is similar in the second
decade of life. In these early ages the papillary differentiation
seems to be morefrequent with higher tendency to present
a locally advanced and high-degree disease at the moment
of the diagnosis , However, when comparing stage by
stage with adult tumors, we find a better response to surgical
treatment and higher survival rates, even with positive nodal
RCC represents 85 to 90% of renal parenchymal malignancies
Among urologic tumors, it is the worst in...