An article by Sabrina Rossi and UM Programme colleagues, published last month in The Surgeon, reviews current evidence on risk stratification for kidney cancer screening.
As kidney cancer is often asymptomatic, resulting in late diagnosis and poor prognosis, earlier detection and screening for kidney cancer have been identified as key research priorities. However, Dr Rossi says, "the low prevalence of the disease in unselected populations limits the cost-effectiveness of population screening. Risk-stratified screening for kidney cancer may improve early detection by targeting high-risk individuals whilst limiting harms in low-risk individuals, potentially increasing cost-effectiveness."
The review summarises evidence for risk-stratified screening using different risk factors, the efficacy of combining kidney cancer screening with other screening programmes, and the use of liquid biomarkers to stratify individuals for more expensive tests. The review also includes evidence of the potential impact and harms of risk-stratified screening, and the public acceptability of various stratification models.
The authors identify promising models and areas requiring further research. While researchers understand the prospective public acceptability of risk-stratified screening, outcomes from the Yorkshire Kidney Screening Trial, the world's first kidney cancer screening feasibility study, will be "crucial in determining the acceptability and feasibility of combined screening for kidney and lung cancers in practice." YKST offered a kidney CT scan as an add-on to a lung screening programme, results of the study are expected early in 2024.
Rossi SH, Harrison H, Usher-Smith JA, Stewart GD. Risk-stratified screening for the early detection of kidney cancer. Surgeon. 2023 Nov 22:S1479-666X(23)00133-6. doi: 10.1016/j.surge.2023.10.010.