ASPO Abstracts
Renal Cell Carcinoma Surgical Treatment Disparities in American Indians
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
PURPOSE OF THE STUDY: This study investigated renal cell carcinoma (RCC) surgical treatment disparity patterns, specifically for American Indian/Alaska Native (AI/AN) individuals in Arizona, and the potential connection to mortality.METHODS: Stage I RCC cases diagnosed between 2007 and 2016, from the Arizona Cancer Registry (ACR) with known race/ethnicity, were included in the study. Census tract socioeconomic factors, including high school graduation, poverty, and unemployment rates were linked. Statistical analyses were performed to test the association of race/ethnicity with surgical treatment pattern and overall mortality adjusting for patient's demographic, healthcare access, and socioeconomic factors.RESULTS: A total of 5,111 patients included from ACR. AI/ANs were the smallest group (n=319; 6.2%). AI/ANs were more likely to live in neighborhoods with lower high school graduation, higher unemployment, and higher poverty rates and rural areas. This group also had a higher proportion of single individuals vs. married. AI/ANs were diagnosed 6 years younger than Non-Hispanic Whites. AI/AN patients are more likely to receive no treatment (OR 1.87 95% CI: 1.24-2.82) and more likely to receive radical rather than partial nephrectomy (OR 1.69 95% CI: 1.25-2.27) compared to NHWs. Analysis showed that not undergoing surgical treatment and undergoing radical nephrectomy had statistically significantly associated with higher overall mortality (HR 1.82 95% CI: 1.21-2.76 and HR 1.59 95% CI: 1.30-1.95 respectively). Although statistically not significant after adjusting for neighborhood-level socioeconomic factors and surgical treatment patterns, AI/ANs had elevated risk of mortality.CONCLUSION: This study illustrates the increased challenges in treatment that AI/AN RCC patients may experiences and the treatment disparities that may lead to high mortality compared to other groups. Increased cancer health programs addressing these specific needs and along with health promotion/prevention programs culturally adapted for this group are required to reduce kidney cancer risks and achieve overall health equity across all groups.
Keywords: American Indians, Kidney Cancer, Surgical Disparities