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Race disparities in Wilms tumor incidence and biology
Jason Axt1, Andrew J Murphy, Erin H Seeley
1Department of Pediatric Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Insights
Black children in Tennessee have a higher incidence of Wilms tumor (WT). Race-specific molecular profiles in WT may explain these disparities and inform future research.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Molecular Pathology
Background:
- Wilms tumor (WT) incidence is reportedly higher in Black African ancestry populations compared to White populations.
- Previous studies suggest potential race-based disparities in Wilms tumor occurrence.
Purpose of the Study:
- To verify increased Wilms tumor incidence in Black children in Tennessee.
- To identify race-specific molecular profiles in Wilms tumor specimens.
Main Methods:
- Utilized the Tennessee Cancer Registry (1999-2008) to assess Wilms tumor epidemiology by race in children under 20.
- Analyzed six Black and four White Wilms tumor specimens using imaging mass spectrometry (IMS).
Main Results:
- Black children represented 29% of Wilms tumor cases, significantly higher than their proportion in other childhood cancers (18.5%).
- Wilms tumor occurred 79% more frequently in Black children than White children in Tennessee.
- Imaging mass spectrometry identified race-specific peptide spectra in Wilms tumor tissue with over 80% accuracy.
Conclusions:
- Black children in Tennessee exhibit a higher susceptibility to Wilms tumor.
- Distinct molecular profiles associated with race were identified in Wilms tumors.
- These findings suggest a biological basis for race disparities in Wilms tumor incidence and biology.
Background:
Wilms tumor (WT) is thought to arise in children of Black African ancestry with greater frequency than in Whites. To clarify the biological basis for race disparities in WT, we first verified that Black children residing in Tennessee have an increased incidence of WT, and second, established molecular profiles in WT that are specific to race.
Materials And Methods:
To assess race disparities in WT epidemiology, the Tennessee Cancer Registry (TCR) was queried for all in-state patients less than 20 y of age and registered between 1999 and 2008. To explore race disparities in WT biology, six Black and four White WT specimens acquired in Tennessee were analyzed using imaging mass spectrometry (IMS).
Results:
TCR data show that Black children are over-represented among WT patients (29%) relative to all other childhood cancers (18.5%; P = 0.01). WT ranked the fifth most common cancer diagnosis among Blacks, but ninth among Whites. The diagnosis of WT occurred 79% more frequently among Blacks (n = 28) than Whites (n = 69; P = 0.01), and proportionally more Blacks tended to present with distant disease. Although overall survival from WT was not statistically different between Blacks (92.9%) and Whites (94.0%), Black males showed the lowest survival (85%; P = 0.21). IMS analysis identified peptide spectra from both WT blastema and stroma that independently classify specimens according to race with greater than 80% accuracy.
Conclusions:
In Tennessee, Black children appear more susceptible than Whites to develop WT. Race-specific molecular profiles can be determined that may help to clarify pathways of Wilms tumorigenesis and the biological basis for race disparities in WT incidence and biology.
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