Kidney cancer risk factors: what raises the risk

What kidney cancer is

The kidneys are two fist-sized organs on either side of the backbone, above the waist. Tubes inside them filter and clean the blood, taking out waste and making urine. Kidney cancer forms in the lining of tiny tubes inside the kidneys (MedlinePlus).

Kidney cancer is not the same as chronic kidney disease, where the kidneys slowly lose their ability to filter blood. For that, see kidney disease risk factors. Cancer that starts in the renal pelvis or the ureters is called urothelial cancer and is a different disease from renal cell cancer (NCI PDQ genetics).

Risk factors

Kidney cancer becomes more likely as you age (MedlinePlus). NCI lists these risk factors for renal cell cancer (NCI PDQ):

• Smoking tobacco. This is a risk factor you can change (NCI PDQ). If you smoke, the quit smoking help check covers the help available to quit.
• Misusing certain pain medicines for a long time, including over-the-counter pain medicines (NCI PDQ) (MedlinePlus).
• Excess body weight (NCI PDQ). The BMI calculator shows where your weight falls.
• High blood pressure (NCI PDQ). See high blood pressure risk factors for what raises blood pressure.
• A family history of renal cell cancer (NCI PDQ).
• Certain genetic conditions, such as von Hippel-Lindau disease or hereditary papillary renal cancer (NCI PDQ). These are covered below.

Many risk factors do not directly cause cancer. They raise the chance of DNA damage in cells that may lead to renal cell cancer. Having one or more of them does not mean you will get it: many people with risk factors never do, while others with no known risk factors do. NCI advises talking with your doctor if you think you may be at risk (NCI PDQ).

Inherited kidney cancer

Most of the time, kidney cancer risk is not passed down from parent to child. Hereditary kidney cancer makes up only 5% to 8% of all kidney cancers and is usually linked to a hereditary cancer syndrome. It is often found at a younger age than kidney cancer that is not inherited (NCI PDQ genetics). NCI describes four syndromes (NCI PDQ genetics):

• Von Hippel-Lindau disease (VHL). A rare syndrome caused by changes in the VHL gene. It raises the risk of kidney cancer (a clear-cell type that is typically slow growing) and kidney cysts, and can cause tumors in other parts of the body, including the brain and spinal cord, the eye, the pancreas and the adrenal glands.
• Hereditary leiomyomatosis and renal cell cancer (HLRCC). Caused by changes in the FH gene. It is linked to a type of kidney cancer that can be fast growing, and may also cause benign tumors in the skin and uterus (fibroids). HLRCC was thought to be rare, but it may be one of the most common hereditary cancer syndromes.
• Birt-Hogg-Dubé syndrome (BHD). A rare syndrome caused by changes in the FLCN gene. It raises the risk of several types of kidney cancer that are typically slow growing, and can cause skin growths, lung cysts and collapsed lung.
• Hereditary papillary renal cancer (HPRC). A rare syndrome caused by changes in the MET gene. It raises the risk of papillary kidney cancer, which is typically slow growing.

Each of these is passed on in an autosomal dominant way: a child of a parent with the syndrome has a 1 in 2 chance of inheriting the gene change (NCI PDQ genetics). People may be referred for genetic counseling and testing if there is (NCI PDQ genetics):

• a family history of several relatives with kidney cancer
• kidney cancer at a young age
• several tumors in one kidney, or cancer in both kidneys
• a type of kidney cancer that is commonly inherited

Families with these syndromes are watched closely for signs of disease in the kidneys and other organs (NCI PDQ genetics).

Signs to check with a doctor

There may be no signs or symptoms in the early stages; they may appear as the tumor grows. They can also be caused by conditions other than cancer. Check with your doctor if you have (NCI PDQ) (MedlinePlus):

• blood in the urine
• a lump in the abdomen
• a pain in the side that does not go away
• loss of appetite
• weight loss for no known reason
• anemia

Tests to diagnose kidney cancer include blood, urine and imaging tests, and sometimes a biopsy (MedlinePlus). Blood in the urine can also be a sign of bladder cancer or kidney stones; see bladder cancer risk factors and kidney stones risk factors. All cancer checks are on the cancer screening hub.

Common questions

Is kidney cancer genetic?

Usually not. Hereditary kidney cancer makes up only 5% to 8% of kidney cancers, mostly linked to syndromes such as VHL, HLRCC, BHD and HPRC (NCI PDQ genetics). A family history of renal cell cancer still raises the risk (NCI PDQ).

Does alcohol raise kidney cancer risk?

Alcohol is not on the list of renal cell cancer risk factors in NCI's patient summary, and MedlinePlus does not list it either (NCI PDQ) (MedlinePlus). Alcohol does raise the risk of several other cancers; the alcohol and cancer risk guide covers which.

Which risk factors can I change?

Smoking can be changed (NCI PDQ). Of the other factors NCI lists, excess weight, high blood pressure and long-term misuse of pain medicines are ones to talk over with your doctor; age, genes and family history cannot be changed (NCI PDQ).