A review of 212 cases of renal cell carcinoma diagnosed during a 40-year period revealed an increasing number of cases detected during imaging studies performed for nonurological reasons. These so-called incidentally detected renal cell carcinomas are increasing in incidence, generally of low stage and associated with significantly improved survival, and they constitute the majority of the patients with improved prognosis during the recent 2 decades. The clinical course and disease stage in patients who continue to present with symptoms of the disease have not changed in the last 40 years. These data suggest that with currently available treatments for renal cell carcinoma a principal method to improve the prognosis of this disease would be through earlier detection. Low disease incidence would mitigate against morphological screening but case finding techniques may prove useful.
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