Kidney cancer is the 10th most common cancer for men and women and makes up four percent of all new cancers. There is a lifetime risk of two percent, with an average age of diagnosis of 64. Your kidneys are essential in removing waste products and excessive fluid from the body as urine. They also produce hormones that help regulate blood pressure and control calcium metabolism. Risk factors for developing kidney cancer include smoking, obesity, high blood pressure and a family history of kidney cancer. Currently, there are no standard screening recommendations for kidney cancer, even when an individual has a family history. Therefore, genetic testing can be a powerful tool to learn if you are at increased risk for developing kidney cancer throughout your lifetime.
Hereditary Cancer and Genetics
Approximately 5-10% of all cancers are inherited or hereditary. Hereditary cancers are caused by a mutation (change) in certain genes that are passed down from parents through genetic material. Currently, there are about 20 different genes associated with kidney cancer. Changes in these genes increase a person’s risk of developing one or more types of cancer, however, not all people who inherit the changed gene will develop cancer. If an altered gene is found, whether or not that individual develops cancer, they do have a 50% chance to pass on the altered gene to each of their children since we have two copies of each of our genes.
Genetic Testing
Recent data has found that about 16% of patients with advanced kidney cancer, which is cancer that starts in the kidney but spreads outside of it, have a mutation for a hereditary cancer syndrome. Genetic testing looks at an individual’s genes to see if they may have inherited an increased risk for cancer.
Genetic testing can be done for many reasons, including:
- To help determine the chance that one may develop cancer or may develop another cancer.
- To obtain information to assist with decisions regarding prevention, medical management and treatment of one’s cancer.
- To find out the chance that one’s close relatives may someday develop cancer.
The cost of hereditary genetic testing has decreased considerably over the past several years and most insurances cover that cost as well as the fee for meeting with a genetic counselor. If results of genetic testing show an increased risk of hereditary cancer, a genetic counselor can discuss steps they might take to prevent cancer, such as participating in early and regular screenings.
Is Genetic Testing for You?
In 2020, updated national guidelines suggested that individuals diagnosed with kidney cancer at age 46 years old or younger, those who have had a multifocal kidney cancer (which is when there are multiple tumors in one kidney), or have had multiple kidney cancers, should consider genetic testing. Individuals without cancer who have two or more family members with kidney cancer or a family member who meets testing guidelines but is unable or unwilling to test, should also consider genetic testing. There are rare types of kidney cancer that can be more concerning for a hereditary syndrome, including papillary or chromophobe. If someone has one of these types of kidney cancer, they should also consider genetic testing.
Unsure about genetic testing? A genetic counselor can help determine which test is best for you and discuss how the results may be used to inform your medical decisions. Genetic counselors are available for in-person appointments as well as over the telephone or telehealth visits. Visit https://findageneticcounselor.nsgc.org/ to connect with a genetic counselor near you.
Lindsey Byrne, MS, CGC, specializes in genitourinary cancer genetics and is an assistant professor at The Ohio State University Comprehensive Cancer Center. She is a licensed and board-certified genetic counselor.
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