Pan-cancer clinical and molecular analysis of racial disparities

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)800-807
Number of pages8
JournalCancer
Volume126
Issue number4
DOIs
StatePublished - Feb 15 2020

Keywords

  • African Americans
  • RNA
  • epigenomics
  • health care disparities
  • long noncoding
  • microRNAs
  • pan-cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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