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The effect of withdrawal of phenacetin-containing analgesics on the incidence of kidney and urothelial cancer and renal failure.

Incidence data for cancers of the kidney and urinary tract (1973-83) and for end stage renal failure (ESRF) due to analgesic nephropathy (1973-86) were examined by loglinear regression to determine the effect of the withdrawal of phenacetin from analgesic preparations in New South Wales and the Australian Capital Territory. Allowing for the altered age and sex structure of the population, the incidence rate between 1973-83 for ESRF due to analgesic nephropathy, in persons aged between 5 and 54 years, decreased by 4.2% per year while that for ESRF excluding patients with analgesic nephropathy or diabetes increased annually by 1.3%. The incidence rates in persons over 14 years of age for cancer of the renal parenchyma (3.4% per year), renal pelvis (5.5%) and bladder (2.1%) increased significantly more than that for cancer at all sites (1.2%). Thus the decrease in ESRF due to analgesic nephropathy had not, by 1983, been paralleled by a decrease in renal parenchymal or urothelial cancer.