Kidney cancer deaths show overall decrease in Europe

Overall deaths from kidney cancer have now fallen across Europe after peaking in the early 1990s, according to a detailed analysis of mortality rates for 32 countries published in the urology journal BJU International.

The review is based on official death records collated by the World Health Organization from 1984 to 2004.

Male deaths from kidney cancer showed an overall reduction of 13 per cent between 1992 and 2002 across the European Union and female deaths fell by 17 per cent during the same period.

Figures for the previous decade had shown a 17 per cent rise for men and an 11 per cent rise for women.

Women are significantly less likely to die of kidney cancer than men – between 2000 and 2004 the death rate was 1.8 per 100,000 people for women and 4.1 for men.

“It is clear from our study that death rates for kidney cancer peaked in the 1990s and are now showing an overall downward trend” say lead authors Professor Fabio Levi from the University of Lausanne, Switzerland, and Professor Carlo La Vecchia from the University of Milan, Italy.

“However we found wide variations between countries when it came to deaths from kidney cancer and incidence of the disease.”

The largest reductions in kidney cancer deaths between 1992 and 2002 were in Austria (down 33 per cent for men and 32 per cent for women) and Germany (down 31 per cent for both men and women).

When it came to incidence rates, the largest reductions for men between 1992 and 2002 were in Sweden (down 18 per cent) and Finland (down 11 per cent) and for women in Sweden (down 19 per cent) and Denmark (down 12 per cent).

“Our study confirms that overall kidney cancer rates declined in the 1990s and that these decreases have been larger in men, people who are middle-aged and in western European countries” says Professor Levi.

“The fall in male deaths is consistent with the links between tobacco usage and kidney cancer risk as men, particularly those from western Europe, are the group who have shown the most favourable changes in smoking habits over the last few decades.”

There are a number of factors that may play a role in reducing the incidence of kidney cancer and death rates from the disease.

“Dietary factors might also play some role” says Professor Levi. “Although their influence on kidney cancer remains unclear, some studies have shown that people who eat a diet rich in vegetables and fruit are less likely to develop the disease.

“Other factors could include reduced exposure to occupational carcinogens, although the risk of such carcinogens on kidney cancer remains unclear.”

The authors say that there may also be a link with better control of high blood pressure, a known risk factor for the disease, and better control of urinary tract infections.

“The current study quantifies recent reductions in kidney cancer deaths and, to a lesser degree, the incidence of the disease” concludes Professor Levi.

“But apart from the role played by reduced tobacco smoking in men, interpretation of these trends remains open to discussion.”

• The changing pattern of kidney cancer incidence and mortality in Europe. Levi et al. BJU International. 101, 949-958 (April 2008).

• The full paper (available on request) contains detailed tables on the 32 countries included in the study.

• Established in 1929, BJU International is published 23 times a year by Wiley-Blackwell and edited by Professor John Fitzpatrick from Mater Misericordiae University Hospital and University College Dublin, Ireland. It provides its international readership with invaluable practical information on all aspects of urology, including original and investigative articles and illustrated surgery. www.bjui.org

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