dr h.niroomand m.d. aja university of medical sience epidemiology & etiology
TRANSCRIPT
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RENALCELL CARCINOMA
Dr H.Niroomand M.D.Aja University Of Medical
Sience
Epidemiology & Etiology
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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
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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
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The majority of cases are sporadic
only 2% to 3% are familial
Epidemiology
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Thank you