Exploring racial disparities in bladder urothelial cancer: insights into survival and genetic variations

Abstract

Background Bladder urothelial cancer is the most common malignancy of the urinary system and the 10th most common cancer worldwide with incidence appearing to show a geographical and exposure pattern. Advances in genomic technologies provide abundant data and insight into tumors at the single-cell resolution and are usually stored in repositories like The Cancer Genome Atlas (TCGA). However, data sources for the TCGA appear to be focused on European and American populations. The extent to which genomic and survival data can be applied to populations not included in the study remains somewhat uncertain. Methods We explored the genomic and survival characteristics of the TCGA pan-cancer atlas of bladder urothelial cancer. We decluttered these characteristics based on racial groups and compared between and among the races and the overall dataset. Results Significant variations were seen in age groups especially Asians (51–60) years and Blacks (61–70) years compared to Whites and the BLCA dataset with a statistically significant difference in mean diagnosis age (p = 0.0048) between Asians and the whole dataset. Overall survival characteristics were similar but genetic features were vastly different. Significant inter-racial alterations could be seen among genes involved in different pathways, oncogenes, tumor suppressors, cytoband amplification and/or deletion, mutation count, and aneuploidy scores. Conclusion The TCGA pan-cancer atlas for bladder urothelial cancer adequately represents White populations only. The genomic features do not apply to Blacks and Asians. We recommend better coverage for other populations to ensure adequate data for clinicians and researchers.