Conference Abstracts - Summit on Cancer Health Disparities (SCHD26)
Vol. 6, Issue Supplement 1, 2026 · S1-2
The Burden of Multiple Primary Cancers and Non-Cancer Deaths in Renal Cell Carcinoma Survivors in the United States
Yagnapriya Ammakola, MBBS,Manas Pustake, MBBS,Atulya Khosla, MBBS,Avi Harisingani, MBBS,Sakditad Saowapa, MBBS,Saif Syed, MBBS,Mohammad Ganiyani, MBBS,Oboseh Ogedegbe, MBBS,Stevenson Ongsyping, MD
Submission received: 2025-11-06 / Accepted: 2026-01-07 / Published: 2026-01-25
Abstract
Background
Renal cell cancer (RCC) survivors face risks from both primary cancer mortality and competing causes, including second primary malignancies (SPMs). Understanding mortality patterns and SPM distribution is crucial for survivorship care planning.
Methods
This study included 18,955 deceased patients with RCC history from SEER registries (2000-2022). SEER Stat 9.0.42.0 was used for the data. The variables included demographics, tumor characteristics, treatment modalities, causes of death, and sequence of primary cancers. Data were analyzed in SPSS v31. A 2-tailed p-value of less than 0.05 was considered statistically significant.
Results
This analysis included 18955 patients who developed second primary cancer after an initial RCC diagnosis. The majority were white, non-Hispanic (72.9%), Non-Hispanic Black 12.1%, Hispanic (all races) 10.2%. There was a male predominance (69%). Mean age at second primary diagnosis is 71.3 years (SD 10.7) and a median age of 72 years.
36.4% of the patients had localized disease at second primary diagnosis while 25.6% had distant metastasis. Various surgical procedures were performed in 57.8% of the patients, 23.2% of them received chemotherapy and 16.2% received beam radiation. Incidence of second primary diagnosis peaked between 2013-2019 with 1000-1400 cases being diagnosed annually.
Second primary malignancy- Lung and bronchus account for majority (15.1%) of the second primary cases after RCC followed by second renal or contralateral kidney cancer (14.5%), prostate (10.3%), urinary bladder (9.1%), breast (4.5%), pancreas (4.1%), melanoma of skin (3.9%), liver (2.5%), myeloma (2%) and stomach (1.7%).
Mortality- While all patients died, only 17.7% died from kidney and renal pelvis cancer (original or second RCC). Major competing causes include lung and bronchus cancer (11.5%), heart disease (10.7%), miscellaneous malignant cancer (6%), pancreatic cancer (3.8%) and urinary bladder cancer (2.7%).
Conclusion
Higher rates of second RCC (14.5%) and bladder cancer (9.1%) suggest genetic susceptibility or field cancerization. Predominance of lung cancer (15.1%) indicate shared risk factors like smoking or treatment effects. High cardiovascular mortality (10.7%) underscores the importance of cardiovascular risk management. Advanced stage at detection (seen in 25.6%) suggests challenges in surveillance. Incidence of prostate cancer in male (10.3% overall) highlights the need of cancer screening discussions.
RCC patients have high rate of incidence of second primary malignancies, particularly lung cancer and second RCC. Mortality due to competing factors exceed death specifically due to RCC. This analysis supports the importance of risk factor modification like cardiovascular risk assessment and management, genetic counseling, comprehensive surveillance strategies and age-appropriate screening for second primaries.