ASPO Abstracts
Racial and Ethnic Disparities in Preoperative Wait Time for Renal Cell Carcinoma Treatment
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
PURPOSE OF THE STUDY: Kidney cancer is one of 10 most common cancers in the United States.
While studies have documented the effects of surgical wait time (SWT) on mortality, little is known
about factors that may influence SWT. The purpose of this study was to identify determinants
affecting time to surgical treatment for renal cell carcinoma (RCC), which is disproportionately
affecting racial/ethnic minority groups.
METHODS: Medical records of patients diagnosed with RCC who underwent nephrectomy between
2010 and 2020 at Banner-University Medical Center Tucson were reviewed. Patients with a prior
cancer diagnosis were excluded. SWT was defined as the date of diagnostic imaging examination
(e.g., CT and MRI) to date of nephrectomy. Logistic regression analysis was performed to identify
factors associated with longer SWT (>77 days).
RESULTS: A total of 365 patients were included. The median SWT was 77 days (interquartile range
44 to 133). Mean age was 59.1 (SD=12.1) and 57.8 (SD=12.4) in patients who had a shorter SWT (≤
77 days) and a longer SWT, respectively. Patients with Medicaid coverage had 3-fold increased odds
of experiencing a longer SWT (OR, 3.35; 95% CI, 1.60-6.99). Medicaid coverage was highest among
Hispanic Americans (HAs), representing 46.8% of coverage compared to 13.5% in non-Hispanic
Whites (NHWs). Private insurance coverage was highest among NHWs, representing 25.8% of
coverage compared to 22.2% and 9.7% of HAs and Native Americans, respectively. Among HAs,
older age (≥50) was associated with longer SWT, but not among NHWs. Lastly, HAs had increased
odds of a longer SWT compared to NHWs in patients with early-stage RCC (TNM Stage I or II) (OR
2.38, 95%, CI, 1.14-4.96).
CONCLUSIONS: Multiple factors, such as access to care, cardiac co-morbidities, performance
status, stage of presentation, and cultural values, may impact the SWT. The disparities in the SWT
among racial/ethnic minority groups warrant further investigations.
Keywords: Latinos, American Indians, Surgical Disparities