Facilitators and barriers to renal tumour biopsy
Research type
Research Study
Full title
Identifying the facilitators and barriers to implementation of tumour biopsy in the diagnostic pathway for small renal masses
IRAS ID
275481
Contact name
Maxine Tran
Contact email
Sponsor organisation
Royal Free London NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Background to the research:
Kidney tumours are increasingly detected in patients having investigations for unrelated symptoms. Currently, it is not possible to tell whether a tumour is benign or cancer by a scan, blood or urine test. Most patients diagnosed with a kidney tumour are offered surgery, but this carries serious risks. These include a 1 in 20 risk of a major complication requiring intervention such as injury to the bowel, liver or spleen and a 1 in 200 risk of death. A biopsy can usually tell whether a kidney tumour is benign or cancer. Some hospitals offer biopsies for small kidney tumours and it can change the way in which a patient may want to have their tumour treated. Instead of surgery, patients with benign tumours often choose to have monitoring or alternative treatments such as freezing the tumour which has less risks. Most side effects of biopsies (discomfort, bruising and blood in the urine) resolve without treatment. Nearly 6 in 10 kidney tumours are benign or are low grade (59%), meaning that they are unlikely to cause harm. This means that over half of patients can potentially avoid surgery if they have a biopsy.
Aims of the research:
Currently, access to biopsies is not equal across the UK. We want to find out what the barriers are and what action is required to offer a tumour biopsy service to all patients to help guide treatment decision and improve outcomes.
Design and methods used:
We will interview doctors, commissioners, and patients to explore current service and viewpoints on the role of biopsy in the diagnosis of kidney lumps. We will include at least 5 hospitals to cover high, medium and low volume centres and get representation across the health delivery service.
Patient and public involvement:
We have conducted a pre-study online survey with the Kidney Cancer UK (KCUK) charity.
• 140 patients, family members and general public responded
• 89% said that knowing whether a tumour was benign or cancerous would help decide whether or not to have surgery
• 93% thought it was important to find out why some hospitals didn’t offer kidney tumour biopsies
• 94% thought it was important to find out how a tumour biopsy service could be implemented so that every patient had access to it if they wanted
• Only 22% of patients were offered a biopsy
Our patient representatives for this study have been involved in drafting the study protocol and will represent patient views on the trial management committee.
Dissemination:
We will present the findings from this study at national and international clinical meetings. We will also communicate results to the kidney cancer community via social media and the KCUK and Royal Free Hospital websites.REC name
South Central - Berkshire Research Ethics Committee
REC reference
20/SC/0244
Date of REC Opinion
1 Jun 2020
REC opinion
Favourable Opinion