title: Race disparities in Wilms tumor incidence and biology.
abstract: BACKGROUND
  Wilms tumor (WT) is thought to arise in children of Black African ancestry with greater frequency than in Whites. To clarify the biological basis for race disparities in WT, we first verified that Black children residing in Tennessee have an increased incidence of WT, and second, established molecular profiles in WT that are specific to race.
  
  
  METHODS
  To assess race disparities in WT epidemiology, the Tennessee Cancer Registry (TCR) was queried for all in-state patients less than 20 y of age and registered between 1999 and 2008. To explore race disparities in WT biology, six Black and four White WT specimens acquired in Tennessee were analyzed using imaging mass spectrometry (IMS).
  
  
  RESULTS
  TCR data show that Black children are over-represented among WT patients (29%) relative to all other childhood cancers (18.5%; P = 0.01). WT ranked the fifth most common cancer diagnosis among Blacks, but ninth among Whites. The diagnosis of WT occurred 79% more frequently among Blacks (n = 28) than Whites (n = 69; P = 0.01), and proportionally more Blacks tended to present with distant disease. Although overall survival from WT was not statistically different between Blacks (92.9%) and Whites (94.0%), Black males showed the lowest survival (85%; P = 0.21). IMS analysis identified peptide spectra from both WT blastema and stroma that independently classify specimens according to race with greater than 80% accuracy.
  
  
  CONCLUSIONS
  In Tennessee, Black children appear more susceptible than Whites to develop WT. Race-specific molecular profiles can be determined that may help to clarify pathways of Wilms tumorigenesis and the biological basis for race disparities in WT incidence and biology.
authors.affiliation: Department of Pediatric Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Axt
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Murphy
authors.forename: Erin H
authors.initials: EH
authors.lastname: Seeley
authors.forename: Colin A
authors.initials: CA
authors.lastname: Martin
authors.forename: Chase
authors.initials: C
authors.lastname: Taylor
authors.forename: Janene
authors.initials: J
authors.lastname: Pierce
authors.forename: Richard M
authors.initials: RM
authors.lastname: Caprioli
authors.forename: Martin
authors.initials: M
authors.lastname: Whiteside
authors.forename: Harold N
authors.initials: HN
authors.lastname: Lovvorn
mesh_terms: D044383:Black People; D002675:Child, Preschool; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D018426:SEER Program; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013714:Tennessee / Q000453:epidemiology; D044465:White People; D009396:Wilms Tumor / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality / Q000473:pathology; D001741:Black or African American