Renal cell carcinoma: etiology, incidence and epidemiology.
OBJECTIVE
The incidence of renal cell carcinoma has been increasing worldwide. Although the etiology of renal cell carcinoma is largely unknown, recent epidemiological investigations have shed some light on the issue. This article reviews the literature related to etiology, incidence and epidemiology of renal cell carcinoma published between May 1, 2003 and April 30, 2004.


RESULTS
Accumulating evidence has confirmed the increasing incidence of renal cell carcinoma. A racial disparity has been reported for the first time. Being overweight and obesity were confirmed to be risk factors for renal cell carcinoma. Recreational exercise was shown to reduce the risk, whereas a Western-style diet and smoking increased the risk. Occupational exposure may relate to the development of renal cell carcinoma; however, no definite carcinogens have so far been identified. A susceptibility to develop renal cell carcinoma may also exist in relation to the gene polymorphisms of detoxifying enzymes including glutathione S-transferase and cytochrome P450.


CONCLUSIONS
Although high-risk groups for renal cell carcinoma have been identified, a large portion of renal cell carcinoma still has an unknown etiology. Life-style modifications might reduce renal cell carcinoma risks. Further studies are thus needed to explore the etiology of renal cell carcinoma in terms of gene-environment interactions.
Murai
Masaru
M
Department of Urology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan. mmurai@sc.itc.keio.ac.jp
Oya
Mototsugu
M
D002292:Carcinoma, Renal Cell / Q000453:epidemiology* / Q000209:etiology*; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects