Vatsala Mundra, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros, Raj Satkunasivam, Christopher J D Wallis, Dharam Kaushik
INTRODUCTION: Disparities have been documented in the outcomes of various cancers (lung, colorectal, breast) among the Hispanic population compared with non-Hispanic White (NHW) patients. However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. The aim of this study was to investigate the disparities in (1) RCC presentation and (2) the time to treatment initiation between Hispanic and NHW patients.
METHODS: We conducted a comparative analysis using National Cancer Database data from 2004 to 2020 to evaluate disparities in RCC presentation and time to treatment initiation between Hispanic and NHW patients. To minimize inherent differences between the 2 groups, we used 1:1 greedy caliper propensity score matching.
RESULTS: After propensity score matching, we analyzed a cohort of 7798 Hispanic and NHW patients. Hispanic patients had an increased likelihood of presenting with clinical T2b RCC relative to NHW patients (odds ratio 1.28; 95% CI, 1.03-1.60) and were more likely to experience delays in surgery (HR, 1.08; 95% CI, 1.01-1.16; = .017) or any other treatment (HR, 1.08; 95% CI, 1.01-1.16; = .022). Hispanic patients also received chemotherapy later (HR, 1.49; 95% CI, 1.05-2.12; = .027).
CONCLUSIONS: Our data indicate that Hispanic patients often present with more advanced stages of RCC and are likely to experience delays in treatment. This study underscores significant disparities in the presentation and care of RCC between Hispanic and NHW patients, highlighting the need for targeted interventions to address these inequalities.
