TY - JOUR
T1 - Pan-cancer clinical and molecular analysis of racial disparities
AU - Lara, Olivia D.
AU - Wang, Ying
AU - Asare, Amma
AU - Xu, Tao
AU - Chiu, Hua Sheng
AU - Liu, Yuexin
AU - Hu, Wei
AU - Sumazin, Pavel
AU - Uppal, Shitanshu
AU - Zhang, Lin
AU - Rauh-Hain, J. Alejandro
AU - Sood, Anil K.
N1 - Funding Information:
Olivia D. Lara is supported by a National Institutes of Health institutional training grant (5T32CA009599). This work was supported in part by other National Institutes of Health grants (P30CA016672, CA213759, P50CA217685, P50CA098258, and R35CA209904), the Blanton‐Davis Ovarian Cancer Research Program, the American Cancer Society Research Professor Award, and the Frank T. McGraw Memorial Chair in Cancer Research (to Anil K. Sood).
Funding Information:
Olivia D. Lara is supported by a National Institutes of Health institutional training grant (5T32CA009599). This work was supported in part by other National Institutes of Health grants (P30CA016672, CA213759, P50CA217685, P50CA098258, and R35CA209904), the Blanton-Davis Ovarian Cancer Research Program, the American Cancer Society Research Professor Award, and the Frank T. McGraw Memorial Chair in Cancer Research (to Anil K. Sood).
Funding Information:
Lin Zhang reports a research grant from Celgene outside the submitted work. Anil K. Sood reports personal fees from KIYATEC and Merck & Company, Inc, owns stock in Bio‐Path Holdings, and research funding from M‐Trap outside the submitted work. The remaining authors made no disclosures.
Publisher Copyright:
© 2019 American Cancer Society
PY - 2020/2/15
Y1 - 2020/2/15
N2 - 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.
AB - 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.
KW - African Americans
KW - RNA
KW - epigenomics
KW - health care disparities
KW - long noncoding
KW - microRNAs
KW - pan-cancer
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U2 - 10.1002/cncr.32598
DO - 10.1002/cncr.32598
M3 - Article
C2 - 31730714
AN - SCOPUS:85075199452
SN - 0008-543X
VL - 126
SP - 800
EP - 807
JO - Cancer
JF - Cancer
IS - 4
ER -