Renal cell carcinoma represents around 3% of all cancers, with the highest incidence occurring in Western countries.

In 2020, there were an estimated 431,288 new cases of RCC globally, of which 138,611 in Europe. The higher incidence in Europe and North America is hypothesized to be due to a higher prevalence of small renal masses (SRMs) in settings where abdominal imaging is more ubiquitous. In 2020, Lithuania reported the highest overall rate of RCC, followed by Czechia, with estimated age-standardised rates (ASRs) of 14.5/100,000 and 14.42/100,000, respectively.

A person living in Czechia has a 2.83% risk of developing RCC. Generally, during the last two decades until recently, there has been an annual increase of about 2% in incidence both worldwide and in Europe. In 2022, worldwide mortality from RCC was 179,368 deaths (115,600 men and 63,768 women), with a calculated global ASR rate of 1.8/100,000 [8]. In Europe, overall mortality rates for RCC increased until the early 1990s, with rates generally stabilising or declining thereafter. There has been a decrease in mortality since the 1980s in Scandinavian countries and since the early 1990s in France, Germany, Austria, the Netherlands, and Italy.

However, in some European countries (Croatia, Estonia, Greece, Ireland, Slovakia), mortality rates still show an upward trend. Renal cell carcinoma is the most common solid lesion within the kidney and accounts for approximately 90% of all kidney malignancies. It comprises different RCC subtypes with specific histopathological and genetic characteristics . There is a 1.5–2.0:1 predominance in men over women with a higher incidence in the older population.

Aetiology Established risk factors include lifestyle factors such as smoking (hazard ratio [HR]: 1.23–1.58), obesity (HR: 1.71), BMI (> 35 vs. < 25), and hypertension (HR: 1.70). 50.2% of patients with RCC are current or former smokers. By histology, the proportions of current or former smokers range from 38% in patients with chromophobe carcinoma (chRCC) to 61.9% in those with collecting duct/medullary carcinoma. In a recent systematic review diabetes was also found to be detrimental. Having a first-degree relative with kidney cancer is also associated with an increased risk of RCC.

Moderate alcohol consumption appears to have a protective effect for reasons as yet unknown, while any physical activity level also seems to have some protective effect. A number of other factors have been suggested to be associated with higher or lower risk of RCC, including specific dietary habits and occupational exposure to specific carcinogens, but the literature is inconclusive. The most effective prophylaxis is to avoid cigarette smoking and reduce obesity. Genetic risk factors are known to play a role in the development of RCC (see Section 3.5.6 – Hereditary kidney tumours).