Kidney cancer is more prevalent among males than females. Although the symptoms and treatment options for kidney cancer are similar regardless of sex, the outlook tends to be less good for males.

According to the Centers for Disease Control and Prevention (CDC), more than 41,000 males and 24,000 females get kidney cancer every year. Worldwide, kidney cancer accounts for about 5% of cancers in males and 3% of cancers in females.

More males than females receive a diagnosis of kidney cancer, and the disease is often more aggressive. Males typically have larger tumors and a higher grade and stage of disease with less positive outcomes.

This article describes the common symptoms and possible causes of kidney cancer in males. It also outlines the risk factors and current research that might explain why more males than females get kidney cancer.

Kidney cancer is often asymptomatic until its later stages. Doctors discover more than half of all tumors when they are examining a person for a different reason.

The symptoms of kidney cancer are similar for males and females. They include:

  • blood in the urine
  • a lump or swelling in the abdomen
  • pain in the lower back or side
  • a feeling of fullness in the side or flanks
  • fatigue
  • persistent fever
  • appetite loss
  • unexplained weight loss
  • a feeling that something is blocking the bowels
  • general malaise

The symptoms above can have other causes. If a person has one or more of these symptoms, they should talk with a doctor to rule out cancer.

As a 2021 article explains, kidney cancers arise when genetic mutations make kidney cells grow abnormally. The cells may multiply too quickly, die too slowly, or develop abnormally, making them unable to function normally. Scientists believe that mutations in the VHL gene play a role in the development of kidney cancer.

Genetic mutations can have different causes, and most people will not find out the cause of their kidney cancer. However, certain risk factors make kidney cancer more likely to occur.

Research has discovered important risk factors for developing kidney cancer. The American Cancer Society lists the following risk factors, in addition to being male:

  • smoking
  • obesity
  • high blood pressure
  • family history of kidney cancer
  • workplace exposure to certain substances, such as trichloroethylene
  • race, as non-Hispanic Black, American Indian, and Alaska Native people have a higher incidence and mortality rate from kidney cancer than non-Hispanic white people
  • certain medications, such as acetaminophen
  • advanced kidney disease
  • genetic and hereditary risk factors

Some hereditary syndromes can also make kidney cancer more likely. These include:

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

Learn about inherited kidney cancer.

Studies suggest that males are twice as likely as females to develop kidney cancer, although the reasons for this difference remain unclear.

Female sex hormones

One partial explanation is that female hormones, such as estrogen, may play a protective role, helping prevent kidney cancer. Estrogen levels decline as females age, which may explain why females are usually older than males at the time of kidney cancer diagnosis.

Females who have had a hysterectomy have lower estrogen levels and may have an increased risk of developing kidney cancer.

Smoking tobacco

There is evidence that smoking tobacco can increase a person’s chances of developing kidney cancer. Estimates suggest that tobacco smoking is responsible for about 6% of kidney cancer deaths in developed countries.

As males are more likely than females to smoke tobacco, this difference could partly explain the higher incidence of kidney cancer among males.

Genetic differences

Genetic differences between males and females could also explain disparities in the genetic mutations causing kidney cancer.

A 2021 review discusses a difference in the inflammatory tumor environment between males and females. This affects how cancer cells behave and respond to treatment. Males may also have a different immune response, making kidney cancer more aggressive.

Hypertension

Hypertension, or high blood pressure, is a known risk factor for kidney cancer and kidney disease, and it is more common in males than in females. In addition, males with hypertension are 1.32 times more likely to develop kidney cancer.

Hypertension also has indirect links with kidney cancer. Firstly, medications for hypertension may increase the risk of kidney cancer. Secondly, hypertension is a risk factor for kidney disease, and impaired kidney function can increase the risk of kidney cancer.

Obesity

Although having obesity is a risk factor for kidney cancer for both sexes, the risks are slightly higher in females than males.

The National Cancer Institute lists various ways to treat kidney cancer. Doctors might use a single treatment or a combination, depending on several factors.

Kidney cancer treatment options include:

  • partial nephrectomy, in which a surgeon removes a tumor from the kidney
  • simple nephrectomy, which involves a surgeon removing an entire kidney
  • radical nephrectomy, where the surgeon removes a kidney, the surrounding tissue and lymph nodes, and the adrenal gland
  • radiation therapy
  • chemotherapy
  • immunotherapy

There is evidence that males are more likely than females to experience complications from nephrectomies. However, males may respond better to other treatments, such as tyrosine kinase inhibitors and immune checkpoint inhibitors.

Across all stages of kidney cancer, the 5-year relative survival rate in the United States is 76%. This means that people with kidney cancer are, on average, 76% as likely as people without kidney cancer to be alive 5 years after diagnosis. Relative survival rates vary depending on the stage of cancer at diagnosis.

By stage, the 5-year relative survival rates are as follows:

  • Localized: When cancer is only in the kidneys, the 5-year survival rate is 93%.
  • Regional: When cancer has spread to nearby tissues, the rate is 71%.
  • Distant: If cancer has spread throughout the body and is present in other organs, the rate is 14%.

These figures are based on people who received a kidney cancer diagnosis between 2011 and 2017. People who receive a diagnosis now may have a better outlook because treatments improve over time.

Learn more about the outlook for people with kidney cancer.

Kidney cancer is one of the most common types of cancer, and it affects males more often than females.

Kidney cancer tends to be more aggressive in males, often having less positive outcomes than kidney cancer in females.

Smoking, hypertension, and obesity are among the known risk factors for kidney cancer. Males are more likely to smoke and have hypertension than females, which might partly explain the difference in the rates of kidney cancer.