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Race and renal cell carcinoma stage at diagnosis

an analysis of the Surveillance, Epidemiology, and End Results data

Lin, Jiea,b; Kamamia, Christinea; Shriver, Craig D.a,b; Zhu, Kangmina,c

European Journal of Cancer Prevention: July 2019 - Volume 28 - Issue 4 - p 350–354
doi: 10.1097/CEJ.0000000000000484
Research Papers: Urologic Cancer
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To study racial differences in tumor stage at diagnosis among Black and White patients with renal cell carcinoma (RCC) by histologic type and time period. The patients were Black and White patients with RCC from 1999 to 2011 derived from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Multinomial logistic regression was used to assess the associations between cancer stage and race and then stratified by histology and diagnosis year. Compared to Whites, Blacks were less likely to be diagnosed with regional disease [odds ratio (OR)=0.67; 95% confidence interval (CI)=0.60–0.73] or distant disease (OR=0.82; 95% CI=0.74–0.90) after adjusting for age, sex, year of diagnosis, and tumor grade. When stratified by RCC histology, similar results were observed for clear cell (OR=0.71; 95% CI=0.63–0.80), chromophobe (OR=0.51; 95% CI=0.32–0.81), and other histologic type (OR=0.63; 95% CI=0.42–0.96) while the association was not significant for papillary histology. The analyses by time showed a lower likelihood to have regional disease in Black than White in 2003–2006 (OR=0.66; 95% CI=0.55–0.79) and 2007–2011 (OR=0.57; 95% CI=0.49–0.67). Black patients were also less likely to have distant disease in 2007–2011 period (OR=0.76; 95% CI=0.65–0.88). In conclusion, blacks were less likely to be diagnosed at a later stage RCC than Whites regardless of cancer histology. This racial disparity may exist over time during the study period.

aJohn P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center

bDepartment of Surgery

cDepartment of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

Correspondence to Jie Lin, PhD, MPH, John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, 11300 Rockville Pike, Suite 1120, Rockville, MD 20852, USA E-mail: jlin@murthacancercenter.org

Received March 7, 2018

Accepted July 25, 2018

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