Racial and Ethnic Disparities in Renal Cell Carcinoma: An Analysis of Clinical Characteristics

Abstract

Variations in clinical characteristics in underrepresented patients with renal cell carcinoma were investigated. This study included 294 patients and showed Hispanic and Native American patients were more likely to be diagnosed with clear-cell subtype and at a younger age than European American patients. Older Hispanic patients who spoke Spanish were more likely to have advanced stage renal cell carcinoma. Background: Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer than European Americans (EAs). We investigated variations in clinical characteristics of HA and NA patients with renal cell carcinoma (RCC) who were previously underrepresented. Materials and Methods: Clinical records of 294 patients with RCC (151 EAs, 95 HAs, 22 NAs, and 26 others) without prior diagnosis of cancer were reviewed. Logistic regression analysis was performed to understand patients' clinical characteristics. Results: HAs had about 5 years younger average age at diagnosis than EAs (55.8 vs. 60.5 years) and an almost 3-fold increased odds of diagnosis before age 50 years (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.39-5.54). The mean age of diagnosis among NAs was 49.7 years, and NAs had an over 6-fold higher odds of diagnosis at a younger age (OR, 6.23; 95% CI, 2.00-19.46). Clear-cell RCC (ccRCC) was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, whereas only 78.8% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared with EAs (OR, 2.79; 95% CI, 1.15-6.80). Among HAs, older patients and patients who spoke Spanish as their primary language were more likely to have advanced stage RCC at diagnosis (OR, 10.48; 95% CI, 1.69-64.89 and OR, 4.61; 95% CI, 1.38-15.40). Conclusion: HA and NA patients with RCC had different clinical characteristics than EA patients. It is necessary to better understand the clinical characteristics of these underserved HA and NA populations with high kidney cancer burden.

Racial/ethnic disparities in renal cell carcinoma: Increased risk of early‐onset and variation in histologic subtypes

“…A study from northern California showed that HAs were diagnosed at younger age than NHWs . Our previous study in southern Arizona also showed that HAs as well as AIs had a younger age at diagnosis . The current study provides evidence to support these findings and demonstrated major US racial/ethnic groups have an increased risk of early‐onset of RCC.…”

“…Previous studies have also shown that papillary RCC is more common in NHBs than in NHWs, but a few studies investigated variations in RCC histologic subtypes across racial/ethnic groups. We previously found that HAs and AIs from southern Arizona had higher frequencies of ccRCC compared with NHWs . A study from Texas showed that ccRCC was very common among HAs, but in the study from northern California, the frequencies of ccRCC were similar between HAs and NHWs .…”

“…However, AIs/ANs and HAs are underrepresented in clinical and epidemiologic studies of kidney cancer, and clinical and pathological characteristics as well as the pattern of health disparities among them are not well understood . Our previous study of RCC demonstrated that HAs and AIs from southern Arizona were diagnosed with RCC at a younger age than NHWs, and ccRCC was more common among HAs and AIs than NHWs . A study showed that HA RCC patients from northern California had a significantly lower median age at diagnosis than NHWs, and ccRCC was slightly more common in HAs than NHW.…”

Distinct Effect of Body Mass Index by Sex as a Prognostic Factor in Localized Renal Cell Carcinoma Treated with Nephrectomy ~ A Data from Multi-Institutional Study ~

“…However, whether these findings from the Caucasian population consistently can be applied in all races/ethnicity is still unknown. For example, a recent study suggested that RCC in Hispanic Americans and Native Americans have different clinical characteristics compared with European American patients [9,10]. With regard to the Asian patients, the incidence of RCC seems to be less frequent in the Asian population than Caucasian, and treatment outcomes may differ between these ethnicities suggesting that the role of prognostic factors including BMI varies between ethnicities [11,12].…”

Molecular Components of the RCC Grade

“…There is a preponderance of cases in males compared with females. 2 In addition, in the United States, there is a racial predilection for Hispanics and Native Americans among ccRCC cases, 3 which suggests genetic, epigenetic, and environmental factors behind the disease. In addition to sporadic ccRCC, there are familial syndromes whose symptoms include RCC.…”