Renal cell carcinoma (RCC) subtypes differ in molecular characteristics and prognosis. We investigated the associations of RCC subtype with patient demographics, comorbidity, and neighborhood socioeconomic status (nSES).
Using linked California Cancer Registry and Office of Statewide Health Planning and Development data, we identified history of hypertension, diabetes, and kidney disease prior to RCC diagnosis in Asian/Pacific Islander, non-Latino Black, Latino, and non-Latino White adults diagnosed with their first pathologically-confirmed RCC from 2005 through 2015. We used multinomial multivariable logistic regression to model the association of demographics, comorbidity, and nSES with clear cell, papillary, and chromophobe RCC subtype.
Of the 40,016 RCC cases included, 62.6% were clear cell, 10.9% papillary, and 5.9% chromophobe. The distribution of subtypes differed strikingly by race and ethnicity, ranging from 40.4% clear cell and 30.4% papillary in non-Latino Black adults to 70.7% clear cell and 4.5% papillary in Latino adults. In multivariable analysis, non-Latino Black individuals had a higher likelihood of presenting with papillary (odds ratio (OR) 3.99, 95% confidence interval 3.61-4.42) and chromophobe (OR 1.81, 1.54-2.13) vs clear cell subtype compared to non-Latino White individuals. Both hypertension (OR 1.19, 1.10-1.29) and kidney disease (OR 2.38, 2.04-2.77 end stage disease; OR 1.52, 1.33-1.72 non end-stage disease) were associated with papillary subtype. Diabetes was inversely associated with both papillary (OR 0.63, 0.58-0.69) and chromophobe (OR 0.61, 0.54-0.70) subtypes.
RCC subtype is independently associated with patient demographics, and comorbidity.
Targeted RCC treatments or RCC prevention efforts may have differential impact across population subgroups.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2022 Dec 07 [Epub ahead of print]
Daphne Y Lichtensztajn, Brenda M Hofer, John T Leppert, James D Brooks, Benjamin I Chung, Sumit A Shah, Mindy C DeRouen, Iona Cheng
University of California, San Francisco, San Francisco, CA, United States., UC Davis Health System, Sacramento, California, United States., Stanford University, Palo Alto, CA, United States., Stanford University Medical Center URO, Stanford, CA, United States., Stanford University School of Medicine, Stanford, CA, United States., Stanford University, Stanford, CA, United States., University of California, San Francisco, San Francisco, California, United States.