Trends in kidney and renal pelvis cancer mortality and associated risk factors in the United States

Kidney and renal pelvis cancer (KRPC) is a leading cause of cancer death in the United States, yet the mortality trends by sociodemographic characteristics are not well understood. This serial cross-sectional analysis used National Centre for Health Statistics data (1999–2020) to examine kidney and renal pelvis cancer mortality trends among individuals aged ≥ 20, stratified by sex, age, race/ethnicity, and county-level socioeconomic status (SES) (Yost index) and rurality. County-level SES was categorized into distribution-based quintiles, where higher quintiles represented greater SES. Age-standardized mortality trends and average annual percent change were calculated, and age-adjusted multivariate quasi-Poisson regression assessed mortality relative to county-level factors. From 1999 to 2020, overall KRPC mortality declined (average annual percent change [AAPC]: -0.9%, 95% CI [-1.0%, -0.8%]), with decreases observed among men (-1.0%) and women (-1.2%). Black individuals had the most substantial decline (AAPC: -1.3%, 95% CI [-1.8%, -0.7%]) compared with all other racial groups. American Indian and Alaska Native individuals showed no significant changes over the study period. KRPC mortality was approximately 1.2 times higher in counties in the lowest SES quintile compared with the highest quintile. Counties with the highest degree of rurality tended to have the greatest risk of KRPC (Complete rural, < 2500 vs. Metropolitan, > 1 million, 1.0 vs. 0.6). The mortality trends varied by demographics. The close association of mortality with rurality highlights the necessity for focused public health interventions to address specific demographic needs.