Black patients with kidney cancer have worse survival than whites

Among patients with renal cell carcinoma, which is the most common form of kidney cancer, whites consistently have a survival advantage over blacks, regardless of patient or tumor characteristics or surgical treatment. These findings suggest the need for additional efforts to prolong the survival of all patients with kidney cancer.

Since the mid-1990s, the highest incidence of renal cell carcinoma has occurred in black patients, rather than white patients. Prior research has found racial disparities in the survival of patients with renal cell carcinoma, with black patients dying earlier than whites.

This study analyzed national data from nearly 40,000 patients with renal cell carcinoma. It confirmed the poorer survival for black patients compared with whites. The study found that 72.6% of white patients survived for at least 5 years, while 68.0% of black patients did. The white patients had a consistent survival advantage across all subgroups, regardless of gender, age, tumor size or stage, tumor subtype, or type of surgical treatment.

Surprisingly, a higher percentage of tumors in black patients were diagnosed at a localized stage, with smaller tumors, or with a less aggressive subtype of cancer than in whites. These factors should indicate a better prognosis. Also, compared with white patients, a slightly higher percentage of black patients received no surgical treatment, which is associated with a substantially poorer prognosis.

The study's lead author, Wong-Ho Chow, PhD, currently of M.D. Anderson Cancer Center in Houston, explained that additional studies are needed to determine why the disparities exist. “We cannot rule out the possibility that other factors not measured in our study—such as obesity, high blood pressure, access to care, and genetic susceptibility—may be contributing to the persistent disparities,” said Chow.

This study was published in Cancer (2012; doi:10.1038/nrurol.2010.46).
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