- New guidance aims to reduce variation in treatment and
prevent unnecessary surgery, improving care for patients and
supporting healthcare professionals
Hundreds more people with suspected kidney cancer should have a
biopsy to help confirm their diagnosis sooner and treat their
disease more effectively, according to new draft guidelines from
NICE.
NICE has today (Wednesday, 17 September) launched its
consultation on a new draft kidney cancer clinical guideline,
which provides a comprehensive overview of the diagnosis,
treatment, and care of adults with suspected or confirmed renal
cell carcinoma (a type of kidney cancer). The draft guideline has
been developed with clinical experts and patients.
Just over 11,000 people in England are diagnosed with kidney
cancer each year. On finding a lesion in the kidney some people
undergo surgery to remove the whole kidney or a section of it.
Without a biopsy, diagnosis of whether lesion was cancerous or
not can only be confirmed at this time. Removal of a kidney can
have a significant impact on a person's quality of life. By
carrying out a biopsy before surgery, a diagnosis can be
confirmed and a decision can be made that surgery is unnecessary
if the lesion poses no risk to the health of the
person.
It is estimated that at least 600 people a year with renal
lesions 4cm or smaller currently have a biopsy, a procedure where
a small sample of tissue or cells is removed and tested to
determine if they are cancerous.
The recommendations in the new draft guideline could see the
number of biopsies increase to around 1,200 procedures a year,
thereby reducing the number of unnecessary surgeries for benign
lesions and allowing healthcare professionals and patients to
take a more informed approach.
The NICE guideline recommends offering a biopsy to help confirm
the diagnosis and inform treatment options for people with
suspected renal cell carcinoma (RCC), where the cancer has not
spread (known as localised or locally advanced), if they have a
lesion on their kidney which is 4cm or smaller from which a
tissue sample can be taken.
A biopsy can also be considered for people with larger lesions
where scans suggest it is benign or before they have non-surgical
treatments that will destroy the lesion, or if the person
requests one.
The guidance places strong emphasis on patient information and
support, recommending that all patients have access to clinical
nurse specialists with kidney cancer expertise who will give them
personalised care plans including details of their treatment,
follow-up schedules, and clear contact information for when they
need support.
The new guideline also covers the information and support needed
for people affected by kidney cancer throughout all stages of the
care pathway, and recommendations for the diagnosis and
management of heritable genetic conditions that significantly
increase the risk of developing kidney cancer, such as Von
Hippel-Lindau disease (VHL).
Professor Jonathan Benger, deputy chief executive and chief
medical officer at NICE, said: "This new guideline on
kidney cancer represents a significant step forward in providing
useful and useable information to help ensure people receive
consistent, high-quality care.
“Our draft recommendations would likely see an increase in the
number of biopsies and a reduction in the number of surgeries for
benign lesions, meaning patients are spared an operation they
might not need. This is not only better for the patient, but it
also saves the NHS time and money that can be used to care for
more people.”
Professor Grant Stewart, Professor of Surgical Oncology at the
University of Cambridge and topic adviser for the NICE guideline
committee, said: “Kidney cancer is a devastating
disease, and this new useful and useable draft guideline will
help to ensure people receive consistent care and support at
every stage of their treatment.”
NICE's public consultation on the draft kidney cancer clinical
guideline opens today and closes on Tuesday, 28 October
2025.
