Study Explores Racial Disparities in Renal Cell Carcinoma by Stage and Mortality
Research recently published by Valencia et al in the journal Cancers found that advanced-stage kidney cancer is more common in Hispanic American and Native American patients than in non-Hispanic White patients. Using data from the National Cancer Database and the Arizona Cancer Registry, researchers also found that both Hispanic Americans and Native Americans in Arizona have an increased risk of mortality from the disease.
"We knew from our past research that Hispanic Americans and Native Americans have a heavier burden of kidney cancer than non-Hispanic Whites," said Ken Batai, PhD, a Cancer Prevention and Control Program research member at the UArizona Cancer Center and Research Assistant Professor of Urology in the College of Medicine - Tucson. “But we also know that around 90% of the Hispanic population in Arizona is Mexican-American—either U.S.-born or Mexican-born—and we do not think this subgroup is well represented in the national data."
The team examined data from the National Cancer Database and the Arizona Cancer Registry to look for disparities in surgical treatment of kidney cancer. They also investigated the possibility that delayed treatments may result in advanced-stage kidney cancer, which has been associated with high mortality rates in Hispanic Americans and Native Americans.
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They found that Arizona's Hispanic Americans are about two times more likely than non-Hispanic White people to have advanced-stage kidney cancer and have nearly double the risk of mortality from early-stage kidney cancer. Similarly, Native Americans are about 30% more likely to have advanced-stage kidney cancer and face a 30% increased risk of mortality from early-stage kidney cancer. These findings suggest that observed disparities in kidney cancer mortality risk cannot be explained by delays in treatment.
The researchers utilized state data to organize Hispanic Americans into various subgroups, including U.S.-born Mexican Americans. They determined this group to have a three times higher risk of mortality compared with non-Hispanic White Americans. National cancer statistics do not break down subgroups within the general Hispanic population; thus, risks to U.S.-born Mexican Americans living in Arizona may be understated in national reporting.
Dr. Batai attributed the discrepancy in national vs state data to the data-collection process. The National Cancer Database relies on hospital-based reporting, whereas the state registry is population-based. Many small hospitals and clinics in rural settings may not report to the National Cancer Database, which could explain the misrepresentation of Hispanic Americans in Arizona.
"To this point, there has been no research documenting this disparity in Hispanic Americans," Dr. Batai said. "This can be very useful information to share with primary care providers and urologists who may not yet be aware."
The research could drive further investigation into why Arizona's Hispanic and Native American populations face increased risks from kidney cancer.
"We know these populations also have higher prevalence of diabetes and blood pressure, both of which are risk factors for kidney cancer," Dr. Batai explained. "While we continue to explore differences in kidney cancer surgical treatment across these groups, we are investigating if there are biologic bases in kidney cancer disparities."
Disclosure: For full disclosures of the study authors, visit mdpi.com.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.