Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer
Objectives To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis.Design Multicentre prospective observational cohort study.Setting and participants Eleven UK centres recruiting pati...
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BMJ Publishing Group
2020-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/5/e035938.full |
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| author | Michelle Wilson Naveen S Vasudev Grant D Stewart Adebanji Adeyoju Jon Cartledge Michael Kimuli Shibendra Datta Damian Hanbury David Hrouda Grenville Oades Poulam Patel Naeem Soomro Mark Sullivan Jeff Webster Peter J Selby Rosamonde E Banks |
| author_facet | Michelle Wilson Naveen S Vasudev Grant D Stewart Adebanji Adeyoju Jon Cartledge Michael Kimuli Shibendra Datta Damian Hanbury David Hrouda Grenville Oades Poulam Patel Naeem Soomro Mark Sullivan Jeff Webster Peter J Selby Rosamonde E Banks |
| author_sort | Michelle Wilson |
| collection | DOAJ |
| description | Objectives To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis.Design Multicentre prospective observational cohort study.Setting and participants Eleven UK centres recruiting patients presenting with suspected newly diagnosed RCC. Symptoms reported by patients were recorded and reviewed. Comprehensive clinico-pathological and outcome data were also collected.Outcomes Type and frequency of reported symptoms, incidental diagnosis rate, metastasis-free survival and cancer-specific survival.Results Of 706 patients recruited between 2011 and 2014, 608 patients with a confirmed RCC formed the primary study population. The majority (60%) of patients were diagnosed incidentally. 87% of patients with stage Ia and 36% with stage III or IV disease presented incidentally. Visible haematuria was reported in 23% of patients and was commonly associated with advanced disease (49% had stage III or IV disease). Symptomatic presentation was associated with poorer outcomes, likely reflecting the presence of higher stage disease. Symptom patterns among the 54 patients subsequently found to have a benign renal mass were similar to those with a confirmed RCC.Conclusions Raising public awareness of RCC-related symptoms as a strategy to improve early detection rates is limited by the fact that related symptoms are relatively uncommon and often associated with advanced disease. Greater attention must be paid to the feasibility of screening strategies and the identification of circulating diagnostic biomarkers. |
| format | Article |
| id | doaj-art-6cfcf49e402e4693a956dc28fe5252e7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6cfcf49e402e4693a956dc28fe5252e72025-02-07T12:30:12ZengBMJ Publishing GroupBMJ Open2044-60552020-05-0110510.1136/bmjopen-2019-035938Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancerMichelle Wilson0Naveen S Vasudev1Grant D Stewart2Adebanji Adeyoju3Jon Cartledge4Michael Kimuli5Shibendra Datta6Damian Hanbury7David Hrouda8Grenville Oades9Poulam Patel10Naeem Soomro11Mark Sullivan12Jeff Webster13Peter J Selby14Rosamonde E Banks156Auckland City Hospital, Department of Cancer and Blood, Auckland, New ZealandLeeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UKDepartment of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UKDepartment of Urology, Stockport NHS Foundation Trust, Stockport, Stockport, UKDepartment of Urology, Saint James’s University Hospital, Leeds, Leeds, UKDepartment of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK, Leeds, UKDepartment of Urology, University Hospital of Wales Healthcare NHS Trust, Cardiff, Cardiff, UKDepartment of Urology, Lister Hospital, Stevenage, Hertfordshire, UKSection of Urological Surgery, Department of Surgery and Cancer, Imperial College London, London, UKDepartment of Urology, Queen Elizabeth University Hospital, Glasgow, Glasgow, UK3Nottingham Hospitals University Trust, Nottingham, Nottinghamshire, UKDepartment of Urology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Newcastle upon Tyne, UKDepartment of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UKDepartment of Urology, Northwick Park Hospital, Harrow, London, UKLeeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UKLeeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UKObjectives To describe the frequency and nature of symptoms in patients presenting with suspected renal cell carcinoma (RCC) and examine their reliability in achieving early diagnosis.Design Multicentre prospective observational cohort study.Setting and participants Eleven UK centres recruiting patients presenting with suspected newly diagnosed RCC. Symptoms reported by patients were recorded and reviewed. Comprehensive clinico-pathological and outcome data were also collected.Outcomes Type and frequency of reported symptoms, incidental diagnosis rate, metastasis-free survival and cancer-specific survival.Results Of 706 patients recruited between 2011 and 2014, 608 patients with a confirmed RCC formed the primary study population. The majority (60%) of patients were diagnosed incidentally. 87% of patients with stage Ia and 36% with stage III or IV disease presented incidentally. Visible haematuria was reported in 23% of patients and was commonly associated with advanced disease (49% had stage III or IV disease). Symptomatic presentation was associated with poorer outcomes, likely reflecting the presence of higher stage disease. Symptom patterns among the 54 patients subsequently found to have a benign renal mass were similar to those with a confirmed RCC.Conclusions Raising public awareness of RCC-related symptoms as a strategy to improve early detection rates is limited by the fact that related symptoms are relatively uncommon and often associated with advanced disease. Greater attention must be paid to the feasibility of screening strategies and the identification of circulating diagnostic biomarkers.https://bmjopen.bmj.com/content/10/5/e035938.full |
| spellingShingle | Michelle Wilson Naveen S Vasudev Grant D Stewart Adebanji Adeyoju Jon Cartledge Michael Kimuli Shibendra Datta Damian Hanbury David Hrouda Grenville Oades Poulam Patel Naeem Soomro Mark Sullivan Jeff Webster Peter J Selby Rosamonde E Banks Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer BMJ Open |
| title | Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer |
| title_full | Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer |
| title_fullStr | Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer |
| title_full_unstemmed | Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer |
| title_short | Challenges of early renal cancer detection: symptom patterns and incidental diagnosis rate in a multicentre prospective UK cohort of patients presenting with suspected renal cancer |
| title_sort | challenges of early renal cancer detection symptom patterns and incidental diagnosis rate in a multicentre prospective uk cohort of patients presenting with suspected renal cancer |
| url | https://bmjopen.bmj.com/content/10/5/e035938.full |
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