RCC review links CT and MRI to overdiagnosis risk

A review published May 26 in International Urology and Nephrology argues that expanded use of CT and MRI may be contributing to overdiagnosis in renal cell carcinoma. The authors wrote that RCC incidence has risen over the past 3 decades while mortality has remained largely stable.

Katherine Vallecilla Valencia and Herney Andres Garcia-Perdomo, both affiliated with Universidad del Valle in Cali, Colombia, authored the review. Springer lists the article as a urology review titled “Overdiagnosis in renal cancer: the hidden consequence of modern imaging.”

Cross-sectional imaging is central to the paper’s argument. The review states that CT and MRI have increased incidental RCC detection, with more than 50% of RCCs now diagnosed incidentally.

Many small renal masses detected this way are benign or biologically indolent, according to the authors. They wrote that earlier detection may help patients with aggressive disease, but can also lead to overtreatment, psychological burden, and higher healthcare costs.

U.S. data show the same incidence-mortality gap discussed in the review. SEER estimates that kidney and renal pelvis cancer incidence rose by an average of 0.7% per year from 2014 to 2023, while death rates fell by an average of 1.1% per year from 2015 to 2024.

The American Cancer Society estimates 80,450 new kidney cancer cases and 15,160 deaths in the U.S. in 2026. ACS also states that part of the long-term rise in kidney cancer diagnoses is probably due to newer imaging tests such as CT, which can detect cancers that might not otherwise have been found.

ACR has published guidance on incidental findings, including incidental renal masses. Its incidental-findings page says ACR uses an evidence-based process to develop algorithm-based recommendations, with transparency and multidisciplinary input.

The ACR Incidental Findings Committee’s renal-mass white paper provides recommendations for renal masses detected incidentally on CT. The paper updated earlier renal guidance from ACR’s 2010 incidental-findings work.

Vallecilla Valencia and Garcia-Perdomo identified active surveillance, radiomics, and AI-based risk stratification as possible ways to reduce harm from overdiagnosis. The review did not generate or analyze new datasets, according to the article page.