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The following is a summary of “Socioeconomic determinants of racial disparities in survival outcomes among patients with renal cell carcinoma,” published in the November 2023  issue of Urology by Alam, et al.

It’s hard to study how racial differences affect results in cancer. Studies examining how race affects renal cell cancer (RCC), results were unclear and couldn’t tell the difference between biological differences and changes in social status. For a study, researchers sought to look into the social factors that lead to differences in overall survival (OS) rates between Black and White RCC patients. They searched the National Cancer Database (NCDB) for people identified with RCC between 2004 and 2017 and had full clinicodemographic information available. Patients with stages (all, cT1aN0M0, and cM1) and subtypes (all, clear cell, or papillary) were examined. They used Cox proportional hazards models and considered disease and social status factors.

Out of the 386,589 people who had RCC, 46,507 (12.0%) were Black. Black patients were younger, more likely to have other health problems, less likely to have insurance, lower income, less likely to have finished high school, more likely to have papillary RCC histology, and more likely to be diagnosed at a later stage of RCC than white patients. Black patients had a 16% higher risk of death at any stage, a 22.5% higher risk of small renal mass (SRM), and a 15% higher risk of metastasis compared to White patients. 

Survival differences were also clear in subanalyses that were based on histology. When it came to patients with SRMs, socioeconomic factors were better at predicting OS than when it came to patients with spread. At every step, black people with RCC have worse mortality rates than white people with the same disease. Socioeconomic differences between races greatly affect how long people can survive in RCC.

Source: sciencedirect.com/science/article/abs/pii/S1078143923002910