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

Abstract

Background Racial/ethnic minority groups have a higher burden of renal cell carcinoma (RCC), but RCC among Hispanic Americans (HAs) and American Indians and Alaska Natives (AIs/ANs) are clinically not well characterized. We explored variations in age at diagnosis and frequencies of RCC histologic subtypes across racial/ethnic groups and Hispanic subgroups using National Cancer Database (NCDB) and Arizona Cancer Registry Data. Methods Adult RCC cases with known race/ethnicity were included. Logistic regression analysis was performed to estimate odds and 95% confidence interval (CI) of early‐onset (age at diagnosis <50 years) and diagnosis with clear cell RCC (ccRCC) or papillary RCC. Results A total of 405 073 RCC cases from NCDB and 9751 cases from ACR were identified and included. In both datasets, patients from racial/ethnic minority groups had a younger age at diagnosis than non‐Hispanic White (NHW) patients. In the NCDB, AIs/ANs had twofold increased odds (OR, 2.21; 95% CI, 1.88‐2.59) of early‐onset RCC compared with NHWs. HAs also had twofold increased odds of early‐onset RCC (OR, 2.14; 95% CI, 1.79‐2.55) in the ACR. In NCDB, ccRCC was more prevalent in AIs (86.3%) and Mexican Americans (83.5%) than NHWs (72.5%). AIs/ANs had twofold increased odds of diagnosis with ccRCC (OR, 2.18; 95% CI, 1.85‐2.58) in the NCDB, but the association was stronger in the ACR (OR, 2.83; 95% CI, 2.08‐3.85). Similarly, Mexican Americans had significantly increased odds of diagnosis with ccRCC (OR, 2.00; 95% CI, 1.78‐2.23) in the NCDB. Conclusions This study reports younger age at diagnosis and higher frequencies of ccRCC histologic subtype in AIs/ANs and Hispanic subgroups. These variations across racial/ethnic groups and Hispanic subgroups may have potential clinical implications.

Renal Cell Carcinoma Health Disparities in Stage and Mortality among American Indians/Alaska Natives and Hispanic Americans: Comparison of National Cancer Database and Arizona Cancer Registry Data

“…Among HAs, Mexican Americans (Mexican descent/Chicano) were the largest group ( n = 3745). As we previously reported, racial/ethnic minority groups had a younger age of diagnosis [ 27 ]. There were more male cases ( n = 252,616) than female cases ( n = 152,457).…”

Race/Ethnicity and Survival in Metastatic Renal Cell Carcinoma: Outcomes for Patients Receiving First Line Targeted Therapies

“…Pathological data suggests variations in the frequency of histological subtype across racial/ethnic groups, with clear cell RCC being more common among Hispanic Americans and American Indians. In contrast, a higher proportion of African American individuals had papillary RCC compared to European Americans [4][5][6][7]. With respect to clinical characteristics, earlier ages of RCC diagnoses in Hispanic, Native American and African American minority groups compared to non-Hispanic whites have been reported [7][8][9].…”

Socioeconomic and health care coverage disparities in children, adolescents, and young adults with sarcoma

“…Differences in age at diagnosis and frequencies of certain cancer subtypes have been also found to exist among certain racial and ethnic groups, suggesting potential biologic differences. In a study exploring disparities in renal cell carcinoma (RCC) among Hispanic, American Indian, and Alaska Natives adults, 16 these minority groups were found to have a higher burden of clear cell RCC than non‐Hispanic White patients. Additionally, they were more likely to be diagnosed at a younger age and have a higher risk of early‐onset RCC.…”

“…In a study exploring disparities in renal cell carcinoma (RCC) among Hispanic, American Indian, and Alaska Natives adults, 16 these minority groups were found to have a higher burden of clear cell RCC than non-Hispanic White patients. Additionally, they were more likely to be diagnosed at a younger age and have a higher risk of early-onset RCC.…”