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Introduction: To gain insight into the scope of patients who may warrant genetic testing for inherited renal cell cancer (RCC), we evaluated the overall prevalence of suspected inherited RCC based on recent consensus criteria and explored race-based differences in specific referral criteria from a 10-year institutional experience.
Methods: We analyzed cancer registry data from 1133 patients (20.1% African American [AA], 76.3% white [Wh], and 3.6% others) who were diagnosed with RCC at our institution from 2004 to 2013. Consensus criteria from the American College of Medical Genetics and Genomics and National Society of Genetic Counselors were used to identify patients with suspected inherited RCC. Referral criteria included clear cell RCC diagnosed at age <50 or papillary RCC (type I or type II). Since early onset RCC is increasingly recognized as an independent indication of hereditary RCC, this was also evaluated.
Results: 22% of patients met criteria for referral for genetic counseling. More AA met referral criteria than Wh (29% vs. 20%, p=0.004). AA were three times more likely than Wh to present with papillary RCC (15% vs. 5%, p<0.001). However, Wh had significantly higher rates of early onset clear cell RCC (56% vs. 33%, p=0.004 ). In the overall cohort, 19% had early onset RCC, with proportionally more AA than Wh (24% vs. 17%, p=0.02).
Conclusion: 1 in 5 RCC patients warrant referral for genetic evaluation for inherited cancer risk. Race-based differences may exist in referral indications for genetic counseling, which has implications for identifying potential underlying hereditary cancer syndromes.