According to the US Surveillance, Epidemiology, and End Results program, the outlook for kidney cancer patients is generally favourable with an overall five year survival rate of 77%, furthermore the survival rate in the 65-74 age category is still 75%. That said, if the patient sufferers from metastasis the survival rate is dramatically reduced, for example patients with metastatic clear cell renal cell carcinoma (ccRCC) have a 5-year survival rate of less than 10%. Given these starkly different outcomes it is therefore important to develop tests to determine who is most at risk.
Jin-Qiu Yuan of Sun Yat-Sen University, Shenzhen, China, and colleagues, examined the relationship between a potential risk marker, serum uric acid (SUA), and the rates of mortality from kidney cancer in the UK biobank dataset. The results were published in the journal Cancer Medicine.
Those in the top quartile of SUA in the UK biobank were more likely to be male, obese, previous smokers, have higher alcohol consumption and lower consumption of fruit and vegetable. They suffered from conditions such as hypertension, diabetes, and gout, and were more likely to use cholesterol lowering medication, and blood pressure medication.
SUA levels were associated with an increased risk of kidney cancer incidence. Participants with the top quartile of SUA had a 45% higher risk of kidney cancer as compared with those in the lowest quartile, after adjustment for confounders. The kidney cancer mortality rate was greater in the highest SUA quartile, compared with the lowest, but this was not statistically significant after confounder adjustment.
SUA therefore seems useful for prediction of kidney cancer incidence, but the value of SUA remains to be determined for the prediction of patients at greatest risk of metastasis and mortality. The number of kidney cancer fatalities in the UK biobank may have been too low to provide statistical confidence.
SUA may still predict metastasis. It is also possible that repeat readings of SUA, once kidney cancer has been detected, may be required for reliable metastasis prediction. The present study only took a single SUA measurement in mostly healthy individuals.
“In conclusion, SUA levels were positively associated with the occurrence of kidney cancer, especially in female subjects. In clinical and public health practice, women with high level of SUA deserve close surveillance for kidney cancer. Management for high SUA may have benefits in kidney cancer prevention. Future studies are required to confirm the causal relationship between SUA and kidney cancer and to investigate the underlying mechanisms,” stated the authors.