Pan-cancer clinical and molecular analysis of racial disparities.

Abstract

BACKGROUND:

Racial disparities in cancer outcomes are increasingly recognized, but comprehensive analyses, including molecular studies, are limited. The objective of the current study was to perform a pan-cancer clinical and epigenetic molecular analysis of outcomes in African American (AA) and European American (EA) patients.

METHODS:

Cross-platform analyses using cancer databases (the Surveillance, Epidemiology, and End Results program database and the National Cancer Data Base) and a molecular database (The Cancer Genome Ancestry Atlas) were performed to evaluate clinical and epigenetic molecular differences between AA and EA patients based on genetic ancestry.

RESULTS:

In the primary pan-cancer survival analysis using the Surveillance, Epidemiology, and End Results database (2,045,839 patients; 87.5% EA and 12.5% AA), AA patients had higher mortality rates for 28 of 42 cancer types analyzed (hazard ratio, >1.0). AAs continued to have higher mortality in 13 cancer types after adjustment for socioeconomic variables using the National Cancer Database (5,150,023 patients; 11.6% AA and 88.4% EA). Then, molecular features of 5,283 tumors were analyzed in patients who had genetic ancestry data available (87.2% EA and 12.8% AA). Genes were identified with altered DNA methylation along with increased microRNA expression levels unique to AA patients that are associated with cancer drug resistance. Increased miRNAs (miR-15a, miR-17, miR-130-3p, miR-181a) were noted in common among AAs with breast, kidney, thyroid, or prostate carcinomas.

CONCLUSIONS:

The current results identified epigenetic features in AA patients who have cancer that may contribute to higher mortality rates compared with EA patients who have cancer. Therefore, a focus on molecular signatures unique to AAs may identify actionable molecular abnormalities.

• Authors: Olivia D Lara, Ying Wang, Amma Asare, Tao Xu, Hua-Sheng Chiu, Yuexin Liu, Wei Hu, Pavel Sumazin, Shitanshu Uppal, Lin Zhang, J Alejandro Rauh-Hain, Anil K Sood
• Journal: Cancer (Cancer) Vol. 126 Issue 4 Pg. 800-807 (02 15 2020) ISSN: 1097-0142 [Electronic] United States
• PMID: 31730714 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 American Cancer Society.

Chemical References

• MicroRNAs

Topics

• Black or African American (genetics, statistics & numerical data)
• Aged
• Epigenesis, Genetic (genetics)
• Female
• Health Status Disparities
• Humans
• Incidence
• Male
• MicroRNAs (genetics)
• Middle Aged
• Neoplasms (epidemiology, ethnology, genetics)
• SEER Program (statistics & numerical data)
• Survival Analysis
• United States (epidemiology)
• White People (genetics, statistics & numerical data)