Many kidney tumours have their origins in genetic mutations that occurred 30–50 years before diagnosis, during childhood or adolescence.
To investigate the genetic underpinnings of kidney cancer, Charles Swanton at the Francis Crick Institute in London, Peter Campbell at the Wellcome Trust Sanger Institute in Hinxton, UK, and their colleagues analysed the genomes of kidney tumours from 33 individuals.
In more than one-third of the tumours, the team found signs that a particular chromosome had ruptured and been partially replaced by chunks of another. This damage had occurred when many patients were still school-aged, although tumours developed only after further mutations accumulated later in life. This long lag time might offer a chance for cancer prevention.
A separate analysis led by Swanton showed that patients tended to fare poorly if their kidney tumours showed low genetic diversity and a large number of alterations to their chromosomes. Such patients were most likely to die early.