How do doctors screen for kidney cancer?

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Testing for kidney cancer when a person does not have symptoms is known as screening. The ACS states that, for those with an average risk of kidney cancer, there are no recommended screening tests.

This is because there is no evidence to show that screening tests lower a person’s risk of dying as a result of kidney cancer.

However, those with a higher risk of developing kidney cancer may need to undergo regular imaging tests, such as computerized tomography (CT), MRI, or ultrasound scans, at younger ages to look for kidney tumors.

Some kidney cancers only receive a diagnosis as a result of a person visiting a doctor when they experience signs and symptoms of kidney cancer. Others receive a diagnosis after a person undergoes an exam for another reason.

There are tests that can detect kidney cancer early. However, none of these carry a recommendation to screen for the disease in people at average risk.

In many cases, doctors diagnose early kidney cancer by accident when performing other tests for a different reason. The survival rate is usually high because doctors have found the cancer in its early stages.

A doctor may detect or suspect symptoms of kidney cancer when performing urinalysis and imaging tests as part of a routine medical checkup.

Urinalysis is a routine urine test that a person may get as a part of a medical checkup. A doctor may find small amounts of blood in the urine, which can be a sign of kidney cancer. However, it is important to note that blood in the urine is a symptom of many other conditions, such as urinary tract or bladder infections and kidney stones.

Imaging tests — an ultrasound, MRI, or CT scan — may help a medical professional discover the presence of tumors or changes in the shape of the kidney that can be due to cancer.

A person may have a high risk of kidney cancer if they have certain inherited conditions, such as:

• von Hippel-Lindau disease
• Birt-Hogg-Dubé syndrome
• hereditary papillary renal cancer
• hereditary leiomyomatosis and renal cell cancer

Doctors often recommend these people have the following tests regularly:

• CT scan: This test takes detailed cross-sectional images of a person’s body. It can also provide information about the size, shape, and location of a tumor and indicates if the cancer has spread beyond the kidney.
• MRI scan: An MRI can indicate if the cancer has grown into major blood vessels in the abdomen. A doctor may also use it to look at abnormal areas in the brain and spinal cord if the cancer has spread.
• Ultrasound scan: Ultrasound machines can help doctors tell the difference between cancerous and noncancerous kidney tumors. The scan may also assist a doctor in guiding a needle during a biopsy.

If a person’s blood relatives have or once had kidney cancer or have an inherited condition with links to the disease, a doctor may recommend genetic testing to the person to see if they also have kidney cancer, as well as counseling.

If a person experiences symptoms and signs of kidney cancer, they should contact a doctor. A doctor will then take a complete medical history and perform a physical exam.

If a doctor suspects that a person has kidney cancer, they will then order further tests. These include:

• Blood tests, such as a complete blood test: Those with kidney cancer often have abnormal blood test results. The test may show that a person has too many red blood cells, known as polycythemia, or too few red blood cells, or anemia. Anemia is a common symptom of kidney cancer. Less commonly, kidney cancer cells create a hormone that causes the bone marrow to create too many blood cells.
• Urine cytology: This can test for blood in the urine, which is a symptom of kidney cancer in nearly half of people with the condition. This test can also show cancer cells in the urine.
• Imaging tests: These can help doctors see if cancer is present and how far it may have spread. A doctor may order:
  • CT scans
  • MRI scan
  • ultrasound
  • angiography
  • chest X-ray
  • bone scan
• Biopsy: Although imaging tests can be enough for a doctor to diagnose kidney cancer, a biopsy may be necessary if the imaging tests are inconclusive. A doctor can perform a fine needle aspiration or a needle core biopsy.

The early stages of kidney cancer may not cause symptoms or signs. However, symptoms can start as the cancer develops.

Symptoms include:

• blood in the urine
• pain between the ribs and hips
• persistent lower back pain on one side
• appetite loss
• unexplained weight loss
• fever
• anemia
• a lump or mass in the kidney area

The above symptoms do not only relate to kidney cancer. It is more likely that a person experiencing one or more of these symptoms has another condition that may require treatment.

A person should speak with a doctor if they experience blood in their urine or a lump or mass in the kidney area.

If a person is experiencing persistent symptoms, such as fever with no known cause, they should also seek help from a medical professional.

There are no recommended kidney cancer screening tests for people who do not have certain risk factors. However, urine tests and imaging scans as part of a routine checkup may detect signs of the disease.

For people with a high risk of kidney cancer, doctors can recommend imaging tests to detect for early signs of the disease.

If a person has a family history of kidney cancer, doctors sometimes use CT scans or renal ultrasounds to search for early stage kidney cancer.

A person should speak with a doctor if they suspect they may have kidney cancer or have symptoms or any signs that their kidneys are not functioning properly.