BACKGROUND We previously observed a rapid increase in the incidence of renal cell carcinoma (RCC) in men and women between 1935 and 1989 in the USA, using data from the Connecticut Tumor Registry. This increase appeared to be largely explained by a positive cohort effect, but no population-based study has been conducted to comprehensively examine age-period-cohort effects by histologic types for the past decade. METHODS We calculated age-adjusted and age-specific incidence rates of the two major kidney-cancer subtypes RCC and renal urothelial carcinoma, and conducted an age-period-cohort analysis of 114 138 incident cases of kidney cancer reported between 1992 and 2014 to the Surveillance, Epidemiology, and End Results programme. RESULTS The age-adjusted incidence rates of RCC have been increasing consistently in the USA among both men and women (from 12.18/100 000 in 1992-1994 to 18.35/100 000 in 2010-2014 among men; from 5.77/100 000 in 1992-1994 to 8.63/100 000 in 2010-2014 among women). Incidence rates generally increased in successive birth cohorts, with a continuing increase in rates among the younger age groups (ages 0-54 years) in both men and women and among both Whites and Blacks. These observations were confirmed by age-period-cohort modelling, which suggested an increasing birth-cohort trend for RCC beginning with 1955 birth cohorts, regardless of the assumed value for the period effect for both men and women and for Whites and Blacks. CONCLUSIONS Known risk factors for kidney cancer may not fully account for the observed increasing rates or the birth-cohort pattern for RCC, prompting the need for additional etiologic hypotheses (such as environmental exposures) to investigate these descriptive patterns.

中文翻译：

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美国肾腺癌发病率长期快速上升，尤其是在年轻人中。

背景我们之前使用康涅狄格州肿瘤登记处的数据观察到，1935 年至 1989 年间，美国男性和女性肾细胞癌 (RCC) 的发病率迅速增加。这种增加似乎主要是由积极的队列效应来解释的，但在过去的十年中，还没有进行基于人群的研究来全面检查组织学类型的年龄-时期-队列效应。方法 我们计算了两种主要肾癌亚型 RCC 和肾尿路上皮癌的年龄调整发病率和年龄特异性发病率，并对 1992 年至 2014 年间报告的 114 138 例肾癌病例进行了年龄-时期-队列分析。监测、流行病学和最终结果计划。结果 在美国，男性和女性的 RCC 发病率一直在上升（男性从 1992-1994 年的 12.18/10 万增加到 2010-2014 年的 18.35/10 万；从 1992 年的 5.77/10 万增加到女性中，从 1994 年到 2010-2014 年的 8.63/100 000）。连续出生队列中的发病率普遍上升，其中男性和女性以及白人和黑人的较年轻年龄组（0-54 岁）的发病率持续上升。这些观察结果得到了年龄-周期-队列模型的证实，该模型表明，从 1955 年出生队列开始，RCC 的出生队列趋势呈增加趋势，无论男性和女性、白人和黑人的周期效应的假设值如何。结论 已知的肾癌危险因素可能无法完全解释观察到的 RCC 增长率或出生队列模式，提示需要额外的病因学假设（例如环境暴露）来研究这些描述性模式。