The National Kidney Cancer Audit (NKCA) have released the second 'State of the Nation' report evaluating patterns of care and outcomes for people diagnosed with kidney cancer in England.
Leading national kidney cancer charity, Kidney Cancer UK, welcomed the findings from the audit and the resulting clinical recommendations. The findings are based on the National Cancer Registration Dataset (NCRD) for 28,579 people diagnosed with kidney cancer in England from 1st January 2018 to 31st December 2022.
Kidney cancer is the sixth most common cancer in the UK – with around 13,800 new kidney cancer cases in the UK every year. Since the 1970s, kidney cancer deaths have increased by 73%, yet when caught early, the 5-year survival rate is over 90% - highlighting the need for effective diagnostic and treatment pathways.
Key findings from the audit include:
- Only 1% (317 people) were recorded to have consented to a clinical trial. Results for individual NHS Trusts vary between 0% and 2%. This is of concern as a considerable number of people with kidney cancer are not getting access to the newest kidney cancer treatments via clinical trials.
- There is also concern that diagnosis of people who have a localised, but relatively large tumour has declined (76% in 2019 to 63% in 2022). This is particularly worrying as these patients are at risk of developing metastatic disease, so they need rapid access to surgery.
- The use of systemic anti-cancer therapy (SACT) was identified in last year’s report as lower than anticipated. There has been a small improvement (48% in 2019 to 50% in 2022), however a large proportion of people with metastatic disease do not receive SACT.
In response to the findings, five clinical recommendations have been developed in collaboration with NKCA Clinical Reference Group to help improve the care of kidney cancer patients. These include:
- Increase the number of people with a small kidney cancer who receive a renal biopsy to confirm the histological diagnosis, by improving availability of timely diagnostics and supporting shared decision making.
- Review pathways for higher risk renal cell carcinoma (RCC) to understand system-level delays and ensure providers prioritise these people over lower-risk cases, treating them within 31 days from decision to treat in England and 21 days in Wales.
- Identify and address reasons why people with kidney cancer, stage T1b-3NX RCC are not considered for surgical treatment and increase the proportion of eligible people assessed and treated.
- Ensure that people with kidney cancer, stage T1aN0M0 RCC are discussed in specialist multidisciplinary team meetings to support consistent and appropriate consideration for nephron sparing treatment.
- Ensure people diagnosed with metastatic RCC are evaluated by a medical/clinical oncologist with expertise in renal cancer management to increase the proportion of people considered for receipt of systemic anti-cancer therapy (SACT) if appropriate.
Commenting on the report findings, Andrew Greaves – General Manager at Kidney Cancer UK – says: “We welcome the findings of the audit as they are a reminder that we urgently need national and local action to address delays in diagnosis and treatment, and to ensure equitable access to innovative therapies for kidney cancer patients.
“The clinical recommendations set out in this report provide a clear and practical roadmap. Now, it is vital that NHS leaders and policymakers take these forward with urgency, so that no patient is left behind in their cancer care.”
The findings also reinforce the results from Kidney Cancer UK’s latest annual patient survey published earlier this year, which highlighted critical gaps in NHS support for kidney cancer patients. In fact, almost two-fifths (39%) of patients were unaware of their cancer’s grade upon starting treatment – which could influence treatment options.
The full report can be accessed here: https://www.natcan.org.uk/reports/nkca-state-of-the-nation-report-2025/
