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.

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.

Several risk factors could make you more likely to develop kidney cancer. But, 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.

Smoking

Smoking increases the risk of 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 slowly over time if you stop smoking.

Excess body weight

People who have excess body weight have a higher risk for RCC. Having excess body weight 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 RCC (even without one of the known inherited conditions listed below) have a higher chance of developing cancer. This risk is highest for people who have a brother or sister with kidney cancer. This might be due to shared genes, something that both family members were exposed to in a shared environment, or both.

Workplace exposure to certain chemicals

Many studies have suggested that being exposed to certain substances at work, such as trichloroethylene or cadmium, increase the risk for RCC.

Being male

RCC is about twice as common in men as in women. This might be because men are more likely to smoke and historically have been more likely to be exposed to cancer-causing chemicals at work.

Race and ethnicity

In the US, kidney cancer rates are highest among American Indian and Alaska Native people. They are slightly higher among African American people than among White people. The reasons for this are not clear.

Certain pain medicines

Some studies have suggested that long-term use of pain medicines such as acetaminophen (and possibly aspirin) may be linked to an increased 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 aren’t working properly.)

Genetic and hereditary risk factors

Some people inherit gene changes from their parents that can increase their risk of RCC. Sometimes this might be the only effect of a gene change. But sometimes it might lead to an inherited syndrome that increases a person’s risk of other health issues (including other cancers), as well.

It’s 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.

To learn more about how some of the gene changes that cause these conditions might lead to kidney cancer, see What Causes Kidney Cancer?

von Hippel-Lindau disease

People with von Hippel-Lindau disease 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 carcinoma

People with hereditary papillary renal carcinoma tend 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 leiomyomatosis and renal cell cancer

People with this syndrome often develop smooth muscle tumors called leiomyomas (fibroids) of the skin and uterus (in women) and have a higher risk for developing papillary RCCs.

This condition has been linked to changes in the FH gene.

Birt-Hogg-Dubé  (BHD) syndrome

People with this syndrome tend to 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.

This condition has been linked to changes in the FLCN gene.

Hereditary paraganglioma-pheochromocytoma syndromes

People with these syndromes often develop neuroendocrine tumors called paragangliomas including tumors in the adrenal gland called pheochromocytomas. They also have an increased risk of RCC.

These conditions are caused by defects in genes such as SDHA, SDHB, and SDHC, and SDHD.

Cowden syndrome

People with Cowden syndrome have a high risk of breast, thyroid, and kidney cancers.

This condition is linked to changes in the PTEN gene.  

Tuberous sclerosis

People with tuberous sclerosis develop many, usually benign (non-cancerous) 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.

This condition is linked to defects in the genes TSC1 and TSC2.

BAP1 tumor predisposition syndrome

People with this condition have an increased risk for some types of skin cancers, as well as melanomas of the eye, mesotheliomas, clear cell RCC, and possibly other cancers. This condition is caused by changes in the BAP1 gene.

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.