Watch small kidney tumours rather than remove them, with a national registry
Most kidney tumours under 3 cm found by chance grow slowly and a fifth are benign. Watching them, with surgery only if they grow, could spare many operations.
The DISSRM registry and Canadian cohorts show growth under 0.3 cm per year and rare metastasis for small renal masses under surveillance. Propose surveillance with renal mass biopsy for grade as the default for masses under 3 cm in patients over 65, with a national registry and explicit intervention triggers.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
- Older and multimorbid patients are excluded and undertreated · Most people with cancer are over 65 but most trial patients are younger and fitter. We guess how to treat the majority.
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Shares Overdiagnosis and false alarms, Renal cell carcinoma.