Geographic Distribution of Racial Differences in Renal Cell Carcinoma Mortality

To examine the geographic variations in Renal cell carcinoma (RCC) -specific death disparities from competing causes among Hispanic, non-Hispanic White, non-Hispanic Black, and Asian/Pacific Islander RCC patients. RCC outcomes in specific racial/ethnic population warrants further research and it is unknown whether racial/ethnic differences in RCC survival vary geographically within the US.

This retrospective cohort study was conducted to assess all RCC patients from 2014 to 2021. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The primary outcome was RCC-related mortality.

The study included 85,975 patients with RCC from 16 geographic areas within the SEER database. Kaplan-Meier analysis showed that Hispanic patients had the worst survival outcome (P < .001 by log rank test). In the multivariable competing-risks regression, Hispanics had a higher risk of cancer-specific mortality (hazard ratio [HR] 1.29, 95% CI, 1.20-1.38, P ˂ .001) compared with non-Hispanic Whites. The increase in the risk of RCC-related death with Hispanic race/ethnicity was consistent across all major subgroups stratified by the covariables. In stratified analyses of geographic regions, there were 3 areas in which Hispanics had worse RCC-specific survival (Los Angeles: HR 1.22, 95% CI, 1.06-1.41, P = .005; Greater California: HR 1.125, 95% CI, 1.15-1.37, P < .001; Atlanta, Georgia: HR 1.95, 95% CI, 1.32-2.88, P = .001).

These results demonstrate that population-level variations in RCC survival among Hispanics and non-Hispanic Whites were associated with a small number of geographic regions. Targeted interventions in these regions may be conducive to alleviating RCC care differences at the national level.