Abstract

Simple SummaryThis study assessed renal cell carcinoma disparities in American Indians/Alaska Natives and Hispanic Americans using the National Cancer Database and the Arizona Cancer Registry, focusing on advanced-stage and mortality. Renal cell carcinoma disparities in American Indians/Alaska Natives have been partially explained by neighborhood socioeconomic factors and residence (rural or urban) pattern, but not in Hispanic Americans. Greater health disparities in renal cell carcinoma stage and mortality for Hispanic Americans and renal cell carcinoma mortality for American Indians/Alaska Natives were observed at the Arizona state level compared to national levels.Renal cell carcinoma (RCC) is one of the top 10 cancers in the United States. This study assessed RCC health disparities in American Indians/Alaska Natives (AIs/ANs) and Hispanic Americans (HAs) focusing on advanced-stage and mortality. RCC patients’ data were obtained from the National Cancer Database (NCDB) and Arizona Cancer Registry (ACR). Logistic and Cox regression analyses were performed to ascertain the effect of race/ethnicity on stage and mortality, adjusting for neighborhood socioeconomic factors, rural/urban residence pattern, and other factors. In both data sets, AIs/ANs had significantly increased odds of advanced-stage RCC in the unadjusted model, but not in adjusted models. Mexican Americans had higher odds of advanced-stage compared to non-Hispanic Whites in NCDB (OR 1.22, 95% CI: 1.11–1.35) and ACR (OR 2.02, 95% CI: 1.58–2.58), even after adjusting for neighborhood characteristics. AIs/ANs did not show increased mortality risk in NCDB after adjusting for neighborhood characteristics, while the association remained significant in ACR (HR 1.33, 95% CI: 1.03–1.72). The great risk of all-cause and RCC-specific mortality was observed in U.S.-born Mexican Americans in Arizona (HR 3.21, 95% CI: 2.61–3.98 and sub-distribution HR 2.79, 95% CI: 2.05–3.81). RCC disparities in AIs/ANs is partially explained by neighborhood factors, but not in HAs.

Highlights

  • Racial/ethnic groups in the United States (U.S.) have different incidences of kidney cancer and mortality rates

  • This study focused on advanced-stage Renal cell carcinoma (RCC), indicative of delayed diagnosis and/or treatment, and mortality in American Indians/Alaska Natives (AIs/ANs) and Hispanic Americans (HAs), previously understudied groups who often live in medically underserved areas

  • Advancedstage RCC was more prevalent in AIs/ANs (31.5%, p < 0.001) and HAs (28.6%, p = 0.02) compared to nonHispanic Whites (NHWs) (27.7%)

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Summary

Introduction

Racial/ethnic groups in the United States (U.S.) have different incidences of kidney cancer and mortality rates. Non-Hispanic Blacks (NHBs) and American Indians and Alaska Natives (AIs/ANs) have higher kidney cancer incidence and mortality rates than nonHispanic Whites (NHWs) [1]. Kidney cancer incidence rates have increased over the last several decades as a result of improved imaging and diagnosis [2]. The greatest increase in kidney cancer incidence rates have been observed in Latin American countries [3,4]. The incidence rates reported for Hispanic Americans (HAs), Latinos/Latinas living in the U.S, are much higher than rates reported in Latin America. In U.S.-Mexico border states, HAs have higher kidney cancer incidence rates than NHWs [5], and the U.S.-born HAs in California and Texas have higher kidney cancer mortality rates than NHWs [6]

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