dr h.niroomand m.d. aja university of medical sience epidemiology & etiology
TRANSCRIPT
RENALCELL CARCINOMA
Dr H.Niroomand M.D.Aja University Of Medical
Sience
Epidemiology & Etiology
accounts for 2% to 3% of all adult malignant neoplasms
most lethal of the common urologic cancers
30% to 40% of patients with RCC have died of theirCancer
Epidemiology
12 new cases are diagnosed per100,000 population
per year
male-to-female predominance of 3 : 2
(6,7th decades)primarily a disease of the elderly
Epidemiology
The majority of cases are sporadic
only 2% to 3% are familial
Epidemiology
The incidence of RCC has increased since the 1970s:
3% per year for whitesFor African-Americans 4% per year
largely related to the more prevalent
use of ultrasonography and CT
Epidemiology
RCC in childhood:
- is uncommon (2.3-6.6) - Mean age is 8 to 9 years
- RCC is as common as Wilms tumor during the 2th decade of life .
Stage for stage, children and young adults may respond better to surgical therapy
Epidemiology
traditionally thought to arise primarily fromthe proximal convoluted tubules(clear cell and papillary)
chromophobe and collecting duct RCC, arederived from the more distal components of the nephron
Etiology
accepted environmental risk factor:
1 - Tobacco exposure: . Relative risks:1.4 to 2.5
. All forms of tobacco use implicated . risk increases with cumulative dose
. accounts for 20% to 30% of cases of RCC in men and 10% to 20% in women
Etiology
2 -Obesity:
- increased relative risk of 1.07 for each unit of rising body mass index
> - 40% of cases of RCC in the US may be causally linked to obesity
- increased insulin-like growthfactor-1, increased circulating estrogen , increased arterionephrosclerosis
& local inflammation
Etiology
3 - Hypertension:
- Diuretics and other antihypertensive medications implicated
- hypertension, rather than the treatment, that increases the risk
- The proposed mechanisms: hypertension-induced renal injury and inflammation, metabolic or functional changes in the renal tubules
Etiology
Although a number of other potential etiologic factors
have been identified in animal models, including : viruses,lead compounds, and more than 100 chemicals such as aromatic hydrocarbons
no specific agent has been definitively
established as causative in human RCC
Etiology
family history of RCC may also be a factor ;
one study showed a relative risk of 2.9 for individuals with a first- or second-degree
relative with RCC
Etiology
Familial Renal Cell Carcinoma (RCC) Syndromes:
1-von Hippel-Lindau Disease
(Clear cell RCC, Hemangioblastomas of the CNS
Retinal angiomas,Pheochromocytoma) 2 -Familial Papillary Renal Cell Carcinoma
3-Hereditary Leiomyomatos and RCC( Type 2 papillary RCC,
Cutaneous leiomyomas Uterine leiomyomas )
4-Birt-Hogg-Dubé Syndrome
Etiology
Thank you