[8] Risk factors for RCC and TCC include smoking, certain pain medications, previous bladder cancer, being overweight, high blood pressure, certain chemicals, and a family history.

[1][2] Risk factors for Wilms' tumor include a family history and certain genetic disorders such as WAGR syndrome.

[15] As kidney cancer becomes more advanced it classically results in blood in the urine, flank or back pain, and a mass.

[15] Other symptoms that are consistent with advanced disease include weight loss, fever, night sweats, palpable swollen lymph nodes in the neck, non-reducing varicocele, bone pain, continuous cough, and bilateral lower leg swelling.

[15][16][17] The classic triad of visible blood in the urine (hematuria), flank pain and palpable abdominal mass occurs in less than 15% of the cases.

RCC may present with signs and symptoms caused by the substances the cancer cell produce (i.e. paraneoplastic syndromes).

[citation needed] Paraneoplastic syndromes caused by kidney cancer can be broadly classified as endocrine and non-endocrine.

[28] However, kidney masses can be due to growth of normal tissue (benign), inflammatory (a reaction of the immune system), or vascular (cells of the blood vessels).

[citation needed] Since there is a large differential diagnosis for a kidney tumor, the first step is to characterize the mass with medical imaging to assess its likelihood of being benign or malignant.

[31][15] Computed tomography (CT) of the abdomen administered with and without IV contrast is the ideal imaging to diagnose and stage kidney cancer.

[32] Since the lungs are the most common organ for kidney cancer to spread to, a chest X-ray or CT scan may be ordered based on the person's risk for metastatic disease.

[36] The renal pelvis is the part of the kidney that collects urine and drains it into a tube called the ureter.

For this reason TCC of the renal pelvis is distinct from RCC and is thought to behave more like bladder cancer.

[31][15] The utility of renal mass biopsy (RMB) lies in that it can confirm malignancy with reliability, can direct therapy based on diagnosis, and can provide drainage.

[15] The TNM staging system classifies the primary tumor (T), lymph nodes (N) and distant metastasis (M) of the disease.

[47] The primary tumor of renal cell carcinoma is categorized in the table below, as according to the AJCC 8th Edition Cancer Staging Manual:[48][49] The lungs are the most common site for metastasis,[31] with other common sites including bone, brain, liver, adrenal gland and distant lymph nodes.

Surgery is not always possible – for example, the patient may have other medical conditions that prevent it, or the cancer may have spread around the body and doctors may not be able to remove it.

[52] Recently, evidence stemming from the KEYNOTE-564 study has shed light on the potential use of systemic therapy in the adjuvant setting, with promising results.

Patients exhibiting specific clear cell RCC tumor characteristics and having undergone treatment with Pembrolizumab for 17 cycles (around 1 year) had significant improvement in disease-free survival.

[57] Sunitinib is the current standard of care in the adjuvant setting along with pazopanib; these treatments are often followed by everolimus, axitinib, and sorafenib.

[58] In the second line setting, nivolumab demonstrated an overall survival advantage in advanced clear renal cell carcinoma over everolimus in 2015 and was approved by the FDA.

[63] In Wilms' tumor, chemotherapy, radiotherapy and surgery are the accepted treatments, depending on the stage of the disease when it is diagnosed.

These include smoking, chemical carcinogens, radiation, viruses, diet and obesity, hypertension, diuretics,[14] and alcohol consumption.

[12] With obesity listed as one of the risk factors, daily physical activity and engaging in a healthy diet is proven to lower the rates of developing kidney cancer in the future.

Sex The incidence of kidney cancer is two times greater in men than in women, and this is thought to be due to biological differences.

Discrepancies in kidney cancer diagnosis has most likely led to the underrepresentation of mortality and incidence in low income countries.

Black people with kidney cancer have lower mortality rates than Caucasians in the United States.