Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ.
Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ.
Clin Genitourin Cancer. 2019 Feb;17(1):e195-e202. doi: 10.1016/j.clgc.2018.10.012. Epub 2018 Oct 27.
Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer than European Americans (EAs). We investigated variations in clinical characteristics of HA and NA patients with renal cell carcinoma (RCC) who were previously underrepresented.
Clinical records of 294 patients with RCC (151 EAs, 95 HAs, 22 NAs, and 26 others) without prior diagnosis of cancer were reviewed. Logistic regression analysis was performed to understand patients' clinical characteristics.
HAs had about 5 years younger average age at diagnosis than EAs (55.8 vs. 60.5 years) and an almost 3-fold increased odds of diagnosis before age 50 years (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.39-5.54). The mean age of diagnosis among NAs was 49.7 years, and NAs had an over 6-fold higher odds of diagnosis at a younger age (OR, 6.23; 95% CI, 2.00-19.46). Clear-cell RCC (ccRCC) was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, whereas only 78.8% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared with EAs (OR, 2.79; 95% CI, 1.15-6.80). Among HAs, older patients and patients who spoke Spanish as their primary language were more likely to have advanced stage RCC at diagnosis (OR, 10.48; 95% CI, 1.69-64.89 and OR, 4.61; 95% CI, 1.38-15.40).
HA and NA patients with RCC had different clinical characteristics than EA patients. It is necessary to better understand the clinical characteristics of these underserved HA and NA populations with high kidney cancer burden.
包括西班牙裔美国人（HAs）和美国原住民（NAs）在内的少数族裔比欧洲裔美国人（EAs）患肾癌的负担更重。我们调查了之前代表性不足的 HA 和 NA 肾细胞癌（RCC）患者的临床特征差异。
回顾了 294 名 RCC 患者（151 名 EA、95 名 HA、22 名 NA 和 26 名其他种族）的临床记录，这些患者以前没有癌症诊断。进行逻辑回归分析以了解患者的临床特征。
HA 的平均诊断年龄比 EA 年轻约 5 岁（55.8 岁 vs. 60.5 岁），50 岁以下诊断的可能性几乎增加了 3 倍（比值比 [OR]，2.77；95%置信区间 [CI]，1.39-5.54）。NA 的平均诊断年龄为 49.7 岁，NA 在较年轻时诊断的可能性高 6 倍以上（OR，6.23；95%CI，2.00-19.46）。透明细胞 RCC（ccRCC）在 HA 和 NA 中比在 EA 中更为常见。超过 90%的 HA 患者患有 ccRCC，而只有 78.8%的 EA 患者患有 ccRCC。HA 与 EA 相比，诊断为 ccRCC 的可能性更高（OR，2.79；95%CI，1.15-6.80）。在 HA 中，年龄较大的患者和以西班牙语为主要语言的患者更有可能在诊断时患有晚期 RCC（OR，10.48；95%CI，1.69-64.89 和 OR，4.61；95%CI，1.38-15.40）。
与 EA 患者相比，RCC 的 HA 和 NA 患者具有不同的临床特征。有必要更好地了解这些服务不足的 HA 和 NA 人群的临床特征，这些人群患肾癌的负担很重。
