Associations of Renal Cell Carcinoma Subtype with Patient Demographics, Comorbidities, and Neighborhood Socioeconomic Status in the California Population


 Background: Renal cell carcinoma (RCC) subtypes differ in molecular characteristics and prognosis. We investigated the associations of RCC subtype with patient demographics, comorbidity, and neighborhood socioeconomic status (nSES). Methods: Using linked California Cancer Registry and Office of Statewide Health Planning and Development data, we identified history of hypertension, diabetes, and kidney disease prior to RCC diagnosis in Asian/Pacific Islander, non-Latino Black, Latino, and non-Latino White adults diagnosed with their first pathologically-confirmed RCC from 2005 through 2015. We used multinomial multivariable logistic regression to model the association of demographics, comorbidity, and nSES with clear cell, papillary, and chromophobe RCC subtype. Results: Of the 40,016 RCC cases included, 62.6% were clear cell, 10.9% papillary, and 5.9% chromophobe. The distribution of subtypes differed strikingly by race and ethnicity, ranging from 40.4% clear cell and 30.4% papillary in non-Latino Black adults to 70.7% clear cell and 4.5% papillary in Latino adults. In multivariable analysis, non-Latino Black individuals had a higher likelihood of presenting with papillary (odds ratio (OR) 3.99, 95% confidence interval 3.61-4.42) and chromophobe (OR 1.81, 1.54-2.13) vs clear cell subtype compared to non-Latino White individuals. Both hypertension (OR 1.19, 1.10-1.29) and kidney disease (OR 2.38, 2.04-2.77 end stage disease; OR 1.52, 1.33-1.72 non end-stage disease) were associated with papillary subtype. Diabetes was inversely associated with both papillary (OR 0.63, 0.58-0.69) and chromophobe (OR 0.61, 0.54-0.70) subtypes. Conclusion: RCC subtype is independently associated with patient demographics, and comorbidity. Impact: Targeted RCC treatments or RCC prevention efforts may have differential impact across population subgroups.