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Understanding racial disparities in renal cell carcinoma incidence: estimates of population attributable risk in two US populations

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Abstract

Purpose

Renal cell carcinoma (RCC) incidence is higher among black than white Americans. The reasons for this disparity remain unclear.

Methods

We calculated race- and sex-specific population attributable risk percentages (PAR%) and their 95% confidence intervals (CI) for hypertension and chronic kidney disease (CKD) among black and white subjects ≥  50 years of age from the US Kidney Cancer Study (USKC; 965 cases, 953 controls), a case–control study in Chicago and Detroit, and a nested case–control study in the Kaiser Permanente Northern California health care network (KPNC; 2,162 cases, 21,484 controls). We also estimated PAR% for other modifiable RCC risk factors (cigarette smoking, obesity) in USKC.

Results

In USKC, the PAR% for hypertension was 50% (95% CI 24–77%) and 44% (95% CI 25–64%) among black women and men, respectively, and 29% (95% CI 13–44%) and 27% (95% CI 14–39%) for white women and men, respectively. In KPNC, the hypertension PAR% was 40% (95% CI 18–62%) and 23% (95% CI 2–44%) among black women and men, and 27% (95% CI 20–35%) and 19% (95% CI 14–24%) among white women and men, respectively. The PAR% for CKD in both studies ranged from 7 to 10% for black women and men but was negligible (<1%) for white subjects. In USKC, the PAR% for current smoking was 20% and 8% among black and white men, respectively, and negligible and 8.6% for black and white women, respectively. The obesity PAR% ranged from 12 to 24% across all race/sex strata.

Conclusions

If the associations found are causal, interventions that prevent hypertension and CKD among black Americans could potentially eliminate the racial disparity in RCC incidence (hypothetical black:white RCC incidence ratio of 0.5).

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Acknowledgments

This work was supported by the Intramural Research Program of the US National Cancer Institute (NCI), National Institutes of Health (NIH).

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Author notes

  1. Mark P. Purdue and Jonathan N. Hofmann contributed equally to this work.

Authors and Affiliations

  1. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA

    Catherine L. Callahan, Nathaniel Rothman, Debra T. Silverman, Mark P. Purdue & Jonathan N. Hofmann

  2. Department of Family Medicine and Public Health Sciences, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA

    Kendra Schwartz & Julie J. Ruterbusch

  3. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Douglas A. Corley & Wei K. Zhao

  4. Department of Urology, Yale School of Medicine, New Haven, CT, USA

    Brian Shuch

  5. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA

    Barry I. Graubard

  6. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Wong-Ho Chow

Authors
  1. Catherine L. Callahan
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  2. Kendra Schwartz
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  3. Douglas A. Corley
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  4. Julie J. Ruterbusch
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  5. Wei K. Zhao
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  6. Brian Shuch
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  7. Barry I. Graubard
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  8. Nathaniel Rothman
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  9. Wong-Ho Chow
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  10. Debra T. Silverman
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  11. Mark P. Purdue
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  12. Jonathan N. Hofmann
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Correspondence to Jonathan N. Hofmann.

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Callahan, C.L., Schwartz, K., Corley, D.A. et al. Understanding racial disparities in renal cell carcinoma incidence: estimates of population attributable risk in two US populations. Cancer Causes Control 31, 85–93 (2020). https://doi.org/10.1007/s10552-019-01248-1

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  • DOI: https://doi.org/10.1007/s10552-019-01248-1

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