Racial disparities in GU cancer metastasis: A comprehensive analysis from 2010-2018.

Abstract

30 Background: Patterns of metastatic spread vary between bladder, kidney, and prostate metastasis. Of these cancers, kidney cancer often spreads to the brain, while prostate cancer is most likely to spread to bone, for example. Sites of metastasis can influence prognosis and in some instances may even direct therapy. The knowledge gap on racial disparities in metastatic patterns merits further investigation. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified bladder, kidney, and prostate cancer patients (2010-2018) in White (W) and Black (B) races. Data on metastasis to the lungs, liver, bones, and brain at diagnosis were extracted. The relative risk (RR) was calculated to compare the metastatic patterns between Black and White patients. P-value, and confidence interval were computed using SPSS 28.0. Results: 3.95% of Black and 1.65% of White patients had metastasis at diagnosis. Black patients had metastasis prevalence of 3.2% lung, 1.8% liver, 4.4% bone, and 0.3% brain. Comparatively, White patients had 1.3%, 0.8%, 3.2%, and 0.3% respectively. For bladder cancer, Black patients had a 60% higher risk for bone and lung metastasis and double the risk for liver metastasis compared to White patients. In kidney cancer, Black patients had a 90% higher brain metastasis risk but 20% lower for bone and lung than White patients. For prostate, Black patients had comparatively heightened risks of bone, lung, and liver metastases by 10%, 20%, and 30%, respectively. Conclusions: Racial disparities are evident in GU cancer metastatic patterns at time of diagnosis. Black patients especially have higher liver metastasis, often associated with poor prognosis. Further studies are vital to unravel biological, socioeconomic, and other contributing factors. [Table: see text]