The Overdiagnosis of Kidney Cancer in Koreans and the Active Surveillance on Small Renal Mass

ABSTRACT

While overtreatment in medical services had been the topic of interest among the medical community for a long time, there are numerous academic papers concerning over-diagnosis nowadays. The use of imaging studies for screening might lead to over-diagnosis of small renal masses (SRMs) therefore the incidence of kidney cancer increased 5 times higher than that of mortality in Korea between 2000 and 2011. The best treatment for SRMs had been debated and the present strategies include surgery, local treatment, and active surveillance. Competing risks to mortality should be considered to determine initial management strategies, and a period of initial active surveillance in patients with SRMs is safe. Tumor growth rate is the primary driver for delayed intervention of SRMs patients, and the risk of metastasis on active surveillance for SRMs is 1%–2% at 2-year follow-up.