ASPO Abstracts
Renal Cell Carcinoma Surgical Treatment Disparities in Hispanic Americans
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
PURPOSE OF THE STUDY: High renal cell carcinoma (RCC) mortality rates in Hispanic Americans (HAs), particularly U.S.-born HAs, have recently reported. This study examined the patterns of disparities for treatment of RCC in HAs and effects of treatment disparities on mortality.METHODS: RCC case data were obtained from National Cancer Database (NCDB) and Arizona Cancer Registry (ACR). Stage I RCC cases with known race/ethnicity were included. Logistic and Cox regression analyses were used to estimate odds ratios (OR) for surgical treatment patterns and Hazards Ratios (HR) for overall mortality separately for HA subgroups adjusting for neighborhood-level socioeconomic characteristics and other factors. In ACR data, sub-distribution Cox proportional hazards regression was performed to evaluate time to death due to RCC accounting for competing risks.RESULTS: A total of 238,141 patients (28,277 HAs) from NCDB and 5,111 patients (859 HAs) from ACR were included. In NCDB, Mexican Americans had increased odd of undergoing radical rather than partial nephrectomy compared to Non-Hispanic Whites (OR 1.29, 95%CI: 1.14-1.47). In ACR, U.S.-born Mexican American had increased odds of not undergoing surgical treatment (OR 2.13, 95%CI: 1.18-3.84). No significantly increased risk of overall mortality was observed for HAs in NCDB. Compared to Non-Hispanic Whites, Mexican Americans, particularly U.S.-born Mexican Americans had increased risk for overall mortality and RCC specific mortality in ACR even after adjusting for neighborhood socioeconomic factors and surgical treatment patterns. In a stratified analysis based on surgical treatment type, a similar pattern of increased risk of overall mortality in Mexican Americans was observed for patient who underwent radical nephrectomy (HR 2.41, 95% CI: 1.56-3.72) and partial nephrectomy (HR 2.37, 95%CI: 1.37-4.09).CONCLUSIONS: This study demonstrated surgical treatment disparities in HAs, but surgical treatment disparities may not be the primary factor for high mortality rates in Mexican Americans. Future studies will further assess the factors contributing surgical treatment disparities and higher mortality in Mexican Americans.
Keywords: Mexican Americans, Kidney Cancer, Surgical Disparities, Neighborhood SES