Risk Factors for Kidney Cancer

A risk factor is anything that increases your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like your age or family history, can’t be changed.

But having a risk factor, or even several risk factors, does not mean that you will get the disease. And some people who get the disease may have few or no known risk factors. Even if a person with kidney cancer has a risk factor, it is often very hard to know how much that risk factor contributed to the cancer.

Scientists have found several risk factors that could make you more likely to develop kidney cancer.

Smoking

Smoking increases the risk of developing renal cell carcinoma (RCC), the most common type of kidney cancer. The increased risk seems to be related to how much you smoke. The risk drops if you stop smoking, but it takes many years to get to the risk level of someone who never smoked.

Obesity

People who are very overweight have a higher risk of developing RCC. Obesity may cause changes in certain hormones that can lead to RCC.

High blood pressure

The risk of kidney cancer is higher in people with high blood pressure. This risk does not seem to be lowered even if someone is taking medicines to treat the high blood pressure. 

Family history of kidney cancer

People with a strong family history of renal cell cancer (without one of the known inherited conditions listed below) have a higher chance of developing this cancer. This risk is highest for people who have a brother or sister with the cancer. It’s not clear whether this is due to shared genes, something that both people were exposed to in the environment, or both.

Workplace exposures

Many studies have suggested that workplace exposure to certain substances, such as trichloroethylene, increases the risk for RCC.

Sex

RCC is about twice as common in men as in women. Men are more likely to smoke and are more likely to be exposed to cancer-causing chemicals at work, which may account for some of the difference.

Race

African Americans have a slightly higher rate of RCC than do White people. The reasons for this are not clear.

Certain medicines

Acetaminophen: Some studies have suggested that acetaminophen, a common pain medicine, may be linked to an increase in the risk of RCC.

Advanced kidney disease

People with advanced kidney disease, especially those needing dialysis, have a higher risk of RCC. (Dialysis is a treatment used to remove toxins from your body if your kidneys do not work properly.)

Genetic and hereditary risk factors

Some people inherit genes that can increase their chances of developing certain types of cancer. The DNA in each of your cells that you get from your parents may have changes that give you this risk.

Some rare inherited conditions can increase a person's risk of kidney cancer. It is important that people who have hereditary conditions linked to RCC see their doctors often, especially if they have already been diagnosed with RCC. Some doctors might recommend regular imaging tests (such as CT scans) to look for new kidney tumors in these people.

Most of the conditions listed here result in a much higher risk for getting kidney cancer, although they account for only a small portion of kidney cancers overall.

von Hippel-Lindau disease

People with this condition often develop several kinds of tumors and cysts (fluid-filled sacs) in different parts of the body. They have an increased risk for developing clear cell RCC, especially at a younger age. They may also have benign tumors in their eyes, brain, spinal cord, pancreas, and other organs; and a type of adrenal gland tumor called pheochromocytoma. This condition is caused by mutations (changes) in the VHL gene.

Hereditary papillary renal cell carcinoma

People with this condition have a tendency to develop one or more papillary RCCs, but they do not have tumors in other parts of the body, as is the case with the other inherited conditions listed here. This disorder is usually linked to changes in the MET gene.

Hereditary leiomyoma-renal cell carcinoma

People with this syndrome develop smooth muscle tumors called leiomyomas (fibroids) of the skin and uterus (in women) and have a higher risk for developing papillary RCCs. It has been linked to changes in the FH gene.

Birt-Hogg-Dube (BHD) syndrome

People with this syndrome develop many small benign skin tumors and have an increased risk of different kinds of kidney tumors, including RCCs and oncocytomas. They may also have benign or malignant tumors of several other tissues. The gene linked to BHD is known as FLCN.

Familial renal cancer

People with this condition develop tumors called paragangliomas of the head and neck region and thyroid cancers. They also tend to get kidney cancer in both kidneys before age 40. It is caused by defects in the genes SDHB and SDHD.

Cowden syndrome

People with this syndrome have a high risk of breast, thyroid and kidney cancers. It is linked to changes in the PTEN gene.  

Tuberous sclerosis

People with this syndrome develop many, usually benign (noncancerous) tumors in different parts of the body including the skin, brain, lungs, eyes, kidneys, and heart. Although the kidney tumors are most often benign, occasionally they can be clear cell RCC. It is caused by defects in the genes TSC1 and TSC2.

Sickle cell trait and disease

Some people inherit a change in a gene that codes for hemoglobin, the protein in red blood cells that helps them carry oxygen. People who inherit this gene change from one parent have sickle cell trait (SCT), but usually don’t have obvious symptoms from it. People who inherit gene changes from both parents have sickle cell disease (SCD). People with either SCT or SCD have an increased risk of renal medullary carcinoma (RMC). This rare subtype of RCC most often occurs in younger people, tends to grow quickly, and can be hard to treat. The increased risk of RMC is thought to be caused by changes in the SMARCB1 gene.