Diagnosis, treatment, and survival from kidney cancer: real‐world National Health Service England data between 2013 and 2019

Conroy, S. et al. (2023) Diagnosis, treatment, and survival from kidney cancer: real‐world National Health Service England data between 2013 and 2019. BJU International, 132(5), pp. 541-553. (doi: 10.1111/bju.16128) (PMID:37436368)

Abstract

Objectives: To report the NHS Digital (NHSD) data for patients diagnosed with kidney cancer (KC) in England. We explore the incidence, route to diagnosis (RTD), treatment, and survival patterns from 2013 to 2019. Materials and Methods: Data was extracted from the Cancer Data NHSD portal for International Classification of Diseases, 10th edition coded KC; this included Cancer Registry data, Hospital Episode Statistics, and cancer waiting times data. Results: Registrations included 66 696 individuals with KC. Incidence of new KC diagnoses increased (8998 in 2013, to 10 232 in 2019), but the age‐standardised rates were stable (18.7–19.4/100 000 population). Almost half of patients (30 340 [45.5%]) were aged 0–70 years and the cohort were most frequently diagnosed with Stage 1–2 KC (n = 26 297 [39.4%]). Most patients were diagnosed through non‐urgent general practitioner referrals (n = 16 814 [30.4%]), followed by 2‐week‐wait (n = 15 472 [28.0%]) and emergency routes (n = 11 796 [21.3%]), with older patients (aged ≥70 years), Stage 4 KCs, and patients with non‐specified renal cell carcinoma being significantly more likely to present through the emergency route (all P < 0.001). Invasive treatment (surgery or ablation), radiotherapy, or systemic anti‐cancer therapy use varied with disease stage, patient factors, and treatment network (Cancer Alliance). Survival outcomes differed by Stage, histological subtype, and social deprivation class (P < 0.001). Age‐standardised mortality rates did not change over the study duration, although immunotherapy usage is likely not captured in this study timeline. Conclusion: The NHSD resource provides useful insight about the incidence, diagnostic pathways, treatment, and survival of patients with KC in England and a useful benchmark for the upcoming commissioned National Kidney Cancer Audit. The RTD data may be limited by incidental diagnoses, which could confound the high proportion of ‘emergency’ diagnoses. Importantly, survival outcomes remained relatively unchanged.

• Item Type: Articles
• Additional Information: This study was supported by the Yorkshire Cancer Research UK (Grant number RA/2019/R1/004). Samantha Conroy has received charitable research funding from The Urology Foundation (2020/21 and 2022/23) and is recipient of the Royal College of Surgeon's 1-year Research Fellowship (2022/23). James W.F. Catto is funded by a Research Professorship from the National Institute for Health and Care Research (NIHR). Rob J. Jones has received grant funding from Exelixis and Roche. Maxine G.B. Tran has received research funding from GSK. Janet E. Brown has received research funding paid to their institution from the NIHR. Vincent Khoo had received research funding paid to their institution for Cancer Research UK (CRUK). Axel Bex received research funding paid to their institution from Pfizer.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jones, Professor Robert
• Authors: Conroy, S., Catto, J. W.F., Bex, A., Brown, J. E., Cartledge, J., Fielding, A., Jones, R. J., Khoo, V., Nicol, D., Stewart, G. D., Sullivan, M., Tran, M. G.B., Woodward, R., and Cumberbatch, M. G.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences
• Journal Name: BJU International
• Publisher: Wiley
• ISSN: 1464-4096
• ISSN (Online): 1464-410X
• Published Online: 12 July 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in BJU International 132(5): 541-553
• Publisher Policy: Reproduced under a Creative Commons licence