The potential for an ultrasound-based screening programme for renal cell carcinoma (RCC) to improve survival through early detection has been the subject of much debate. The prevalence of ultrasound-detected asymptomatic RCC is an important first step to establishing whether a screening programme may be feasible.
A systematic search of MEDLINE and Embase was performed up to March 2016 to identify studies reporting the prevalence of renal masses and RCC. Two populations of patients were chosen: asymptomatic individuals undergoing screening ultrasonography and patients undergoing ultrasonography for abdominal symptoms not related to RCC. A random-effects meta-analysis was performed. Study quality was evaluated using a validated eight-point checklist.
Sixteen studies (413 551 patients) were included in the final analysis. The pooled prevalence of renal mass was 0·36 (95 per cent c.i. 0·23 to 0·52) per cent and the prevalence of histologically proven RCC was 0·10 (0·06 to 0·15) per cent. The prevalence of RCC was more than double in studies from Europe and North America than in those from Asia: 0·17 (0·09 to 0·27) versus 0·06 (0·03 to 0·09) per cent respectively. Data on 205 screen-detected RCCs showed that 84·4 per cent of tumours were stage T1-T2 N0, 13·7 per cent were T3-T4 N0, and only 2·0 per cent had positive nodes or metastases at diagnosis.
At least one RCC would be detected per 1000 individuals screened. The majority of tumours identified are early stage (T1-T2).
The British journal of surgery. 2017 May [Epub]
S H Rossi, R Hsu, C Blick, V Goh, P Nathan, D Nicol, S Fleming, M Sweeting, E C F Wilson, G D Stewart
Academic Urology Group, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK., Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, UK., Division of Imaging Sciences and Biomedical Engineering, King's College London, and Department of Radiology, Guy's and St Thomas' Hospitals NHS Trust, London, UK., Department of Oncology, Mount Vernon Cancer Centre, Northwood, UK., Department of Urology, Royal Marsden Hospital, and Institute of Cancer Research, London, UK., Centre for Forensic and Legal Medicine, University of Dundee, Ninewells Hospital, Dundee, UK., Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK., Cambridge Centre for Health Services Research, University of Cambridge, and Cambridge Clinical Trials Unit, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.