Race Disparities in Wilms Tumor Incidence and Biology

Abstract

Background Wilms tumor (WT) is thought to arise in children of black African ancestry with greater frequency than whites. To clarify the biological basis for race disparities in WT, we first verified that black children residing in Tennessee have an increased incidence of WT, and second, established molecular profiles in WT that are specific to race. Materials and Methods To assess race disparities in WT epidemiology, the Tennessee Cancer Registry (TCR) was queried for all in-state patients less than 20 years of age and registered between 1999–2008. To explore race disparities in WT biology, six black and four white WT specimens acquired in Tennessee were analyzed using imaging mass spectrometry (IMS). Results TCR data show that black children are overrepresented among WT patients (29%) relative to all other childhood cancers (18.5%; p=0.01). WT ranked the 5th most common cancer diagnosis among blacks, but 9th among whites. The diagnosis of WT occurred 79% more frequently among blacks (n=28) than whites (n=69; p=0.01), and proportionally more blacks tended to present with distant disease. Although overall survival from WT was not statistically different between blacks (92.9%) and whites (94.0%), black males showed the lowest survival (85%; p=0.21). IMS analysis identified peptide spectra from both WT blastema and stroma that independently classify specimens according to race with greater than 80% accuracy. Conclusions In Tennessee, black children appear more susceptible than whites to develop WT. Race-specific molecular profiles can be determined that may help to clarify pathways of Wilms tumorigenesis and the biological basis for race disparities in WT incidence and biology.

Imaging mass spectrometry: a new tool for kidney disease investigations

“…The classification of specimens according to the race based on MSI peptide spectra represents an early preview into the biological basis for epidemiologic observations in WT [43].…”

The Role of Hispanic Ethnicity in Pediatric Wilms’ Tumor Survival

“…Denys-Drash syndrome, hemihypertrophy, and several overgrowth syndromes (i.e., Beckwith-Wiedemann, Simpson-Golabi-Behmel, and Perlman syndromes) have been associated with WT [2,6]. In addition, WT has also been linked to congenital conditions outside the context of known genetic syndromes, including mental retardation and urogenital malformations [7,8].…”

“…Some studies have suggested that African-American children may be affected with WT proportionally more often than Caucasian-or Asian-Americans [7,9,5]. One study implied that this disparity may be due, in part, to a higher prevalence of the predisposing congenital anomalies and syndromes among African-American children [9].…”

“…Another study provided tentative evidence that there may be race-specific molecular profiles in WT tissues, indicating that racial disparities in the incidence and survival of this tumor may not be entirely attributable to socioeconomic or other extrinsic factors [7]. The effect of Hispanic ethnicity on WT risk and survival, though, remains understudied.…”

The Journal of Surgical Research – 2012

“…We thank these talented academic surgeons in advance for their service and support of the Journal [19][20][21][22][23][24][25][26][27][28][29].…”