Diagnosis, treatment, and survival from kidney cancer: real-world National Health Service England data between 2013 and 2019

ObjectivesTo report the NHS Digital (NHSD) data for patients diagnosed with kidney cancer (KC) in England. We explore the incidence, route to diagnosis (RTD), treatment, and survival patterns from 2013 to 2019. Materials and MethodsData was extracted from the Cancer Data NHSD portal for International Classification of Diseases, 10th edition coded KC; this included Cancer Registry data, Hospital Episode Statistics, and cancer waiting times data. ResultsRegistrations included 66696 individuals with KC. Incidence of new KC diagnoses increased (8998 in 2013, to 10232 in 2019), but the age-standardised rates were stable (18.7-19.4/100000population). Almost half of patients (30340 [45.5%]) were aged 0-70years and the cohort were most frequently diagnosed with Stage 1-2 KC (n=26297 [39.4%]). Most patients were diagnosed through non-urgent general practitioner referrals (n=16814 [30.4%]), followed by 2-week-wait (n=15472 [28.0%]) and emergency routes (n=11796 [21.3%]), with older patients (aged >= 70years), Stage 4 KCs, and patients with non-specified renal cell carcinoma being significantly more likely to present through the emergency route (all P<0.001). Invasive treatment (surgery or ablation), radiotherapy, or systemic anti-cancer therapy use varied with disease stage, patient factors, and treatment network (Cancer Alliance). Survival outcomes differed by Stage, histological subtype, and social deprivation class (P<0.001). Age-standardised mortality rates did not change over the study duration, although immunotherapy usage is likely not captured in this study timeline. ConclusionThe NHSD resource provides useful insight about the incidence, diagnostic pathways, treatment, and survival of patients with KC in England and a useful benchmark for the upcoming commissioned National Kidney Cancer Audit. The RTD data may be limited by incidental diagnoses, which could confound the high proportion of 'emergency' diagnoses. Importantly, survival outcomes remained relatively unchanged.