Can Kidney Cancer Be Found Early?

Many kidney cancers are found while they are still just in the kidney, but others are found at a more advanced stage. There are a few reasons for this:

• Sometimes these cancers can grow quite large without causing any pain or other problems.
• Because the kidneys are deep inside the body, small kidney tumors cannot be seen or felt during a physical exam.
• There are no recommended screening tests for kidney cancer for people at average risk.

For people at average risk of kidney cancer

Some tests can find some kidney cancers early, but none of these is recommended to screen for kidney cancer in people at average risk.

A routine urine test (urinalysis), which is sometimes part of a medical checkup, might find small amounts of blood in the urine of some people with early kidney cancer. But blood in the urine can also have other causes, including urinary tract or bladder infections, bladder cancer, and benign (non-cancerous) kidney conditions such as kidney stones. Sometimes people with kidney cancer don’t have blood in their urine until the cancer is quite large or has already spread to other parts of the body.

Imaging tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI) can often find small kidney cancers. But these tests can be time consuming and expensive. Ultrasound is less expensive and can also detect some early kidney cancers. But it’s not clear that the benefits of screening for kidney cancer with any of these tests would outweigh the possible downsides. Another issue with these types of tests is that they can’t always tell benign tumors from small kidney cancers. This could mean that a person might need to get other types of tests, such as a biopsy, even if it turns out they don’t have kidney cancer.

Often, kidney cancers are found by accident when imaging tests are done for some other reason. These cancers usually are not causing pain or other symptoms when they are found. The survival rate for these kidney cancers is very high because they are usually found at a very early stage.

For people at increased risk of kidney cancer

People who have certain inherited conditions have a higher risk of kidney cancer. This includes syndromes such as:

• von Hippel-Lindau disease
• Hereditary papillary renal carcinoma
• Hereditary leiomyomatosis and renal cell carcinoma
• Birt-Hogg-Dubé syndrome
• Paraganglioma-pheochromocytoma syndromes
•  BAP1 tumor predisposition syndrome
• Tuberous sclerosis

Doctors often recommend that people with these types of conditions get regular physical exams, possibly along with CT, MRI, or ultrasound scans, usually starting when they are young, to look for kidney tumors (and possibly other types of tumors).  Kidney cancers that are found early this way often can be cured.

Some doctors also recommend that people with kidney diseases treated by long-term dialysis, who are also at increased risk, have regular tests to look for kidney cancer.

Genetic counseling and testing for people who might be at increased risk of kidney cancer

It’s important to tell your doctor if any of your family members (blood relatives) have had kidney cancer, especially at a younger age, or if they have been diagnosed with an inherited condition linked to this cancer, such as von Hippel-Lindau disease. Your doctor may recommend that you consider genetic counseling and testing to see if you have one of these conditions.

Before having genetic tests, it’s important to talk with a genetic counselor so that you understand what the tests can − and can’t − tell you, how the tests are done, and what any results would mean. Genetic tests are used to look for the gene mutations that cause these inherited conditions, not kidney cancer itself. Your risk may be increased if you have one of these conditions, but it does not mean that you have (or definitely will get) kidney cancer. For more information on genetic testing, see Genetic Testing for Cancer Risk.