Epidemiologic and socioeconomic characteristics of Hispanics diagnosed with metastatic renal cell carcinoma in the US.

Abstract

e16555 Background: Annually, there are over 400,000 new renal cell carcinoma (RCC) cases and more than 170,000 deaths worldwide. In the US, 80,000 new cases of RCC are diagnosed each year and almost 14,000 deaths. Over the past half-century, RCC has more than doubled in incidence. RCC seems to have a greater incidence among Hispanics, with a nearly three-fold increase. The epidemiology of RCC in the Caucasian population has been previously studied. However, there is a knowledge gap on disparities in RCC on minority populations. Studying the epidemiology of RCC in Hispanics is integral to our community, where Hispanics make up 70%. Methods: We conducted a retrospective cohort study using the Florida Statewide Cancer Registry to describe the characteristics and rates of metastatic RCC (mRCC) among patients in the State between 1981 and April 2019. We identified ethnicity as Hispanic/Latino (HL) or non-Hispanic/Latino (NHL). Clinical presentation was categorized as mRCC at diagnosis/de novo based on SEER and TNM classification. Results: We analyzed 81,178 patients age 18 and older with an ICD-10 code C649 diagnosis of malignant neoplasm of an unspecified kidney. 69,359 patients (85%) were diagnosed with RCC based on ICD-O classification, and 10,959 (13%) had metastatic disease at the time of diagnosis. Of these patients with metastatic disease, 9,691 (87.12%) were identified as NHL and 1,170 (12.30%) as HL. At the time of diagnosis, more HLs were enrolled in Medicaid (11.99% vs. 4.03%) and were uninsured (9.36% vs. 4.28%) compared to NHLs. Amongst HLs with the country of birth data, 650 (87%) were foreign-born and 97 (13%) were US-born. The largest group of foreign-born HLs was from Cuba, with 337 patients (45.18%). While for both groups the highest number of patients were diagnosed in the seventh decade of life (USA 29.66% vs. foreign 27.23%), USA-born HLs were diagnosed more over the preceding two decades (age 39-58) than foreign-born HLs (45.82% vs. 33.51%). Conversely, foreign-born HLs were diagnosed later than US-born HLs (35.29% vs. 18.34%). Both groups kept the same top two histological diagnoses (RCC and ccRCC) as the general cohort; however, US-born HLs were diagnosed with spindle cell carcinoma almost twice as much as foreign-born HLs (10.27% vs. 5.36%). Lastly, 85% of US-born HLs received treatment after diagnosis of mRCC compared to 78.9% of foreign-born HLs; however, at the last update, 47.17% and 32.95% were alive, respectively. Conclusions: In this cohort of patients with mRCC, 1 of 10 patients diagnosed with mRCC was HL. While characteristics were similar between groups, HLs had differences regarding access to care. Even amongst HLs, the country of origin affected the age of diagnosis, treatments, and outcomes. Further histopathologic and clinical characteristics will be presented at the meeting, along with treatment choices, outcomes, and clinical trial participation in the NHL and HL cohorts.