Racial and gender disparities in renal cell carcinoma.
461 Background: In spite of advancements in early diagnoses and better cancer treatments in the United States, ethnic and gender disparities still exist. In some types of cancer, African Americans and males generally tend to have higher disease frequency and worse outcomes. Studies about survival outcome among various racial groups in RCC are very scarce. Our study compared stage distribution and overall survival in relation to ethnicity and gender in patients with renal cell carcinoma (RCC). Methods: We retrospectively reviewed 205 patients diagnosed with RCC between 1995 and 2008 in a community hospital setting. Patients with additional malignancies, lymphoma of the kidneys, or no follow up data were excluded from the study. Demographics, pathology, disease stage, operative note, and subsequent follow up data were reviewed. Patients were divided into groups according to race and gender. Results: A total of 205 patients were included, Caucasians were 176 (85.9%), African Americans were 13.7% and Asians were 1 (0.5%). Males (M) were 127 (62.3%) and females (F) were 77 (37.7%). The median age of the study population was 65 (22-91). Clear cell histology was seen in 79%. Stage I was seen in 53.9%, II in 23.5%, III in 13.7% and IV in 8.8% of the study population. Advanced stages (III, IV) were seen in 18% of African American and in 23% of Caucasians (p=0.45). Advanced disease (III, IV) was seen in 22% of Females compared to 24% in Males (p=0.6). The 3 year overall survival for the study population was 67.3% (95% CI: 60.4-73.7). The 3 year overall survival for African Americans was 50% compared 71.5% in Caucasians (p=0.02). The 3 year overall survival for Females was 68.4% compared to (68.8%) (p=0.54). Conclusions: Our study showed that in patients with RCC, African Americans had worse survival outcome compared to Caucasians in spite of similar stage distribution. Our study didn’t show any gender based disparity in overall survival. Large studies are necessary to determine the causes of poor survival outcome in African American population in RCC.