TY - JOUR
T1 - Impacts of Neighborhood Characteristics and Surgical Treatment Disparities on Overall Mortality in Stage I Renal Cell Carcinoma Patients
AU - Cruz, Alejandro
AU - Dickerson, Faith
AU - Pulling, Kathryn R.
AU - Garcia, Kyle
AU - Gachupin, Francine C.
AU - Hsu, Chiu Hsieh
AU - Chipollini, Juan
AU - Lee, Benjamin R.
AU - Batai, Ken
N1 - Funding Information:
This study was supported by funding from National Cancer Institute (1R21CA248361-01, P30CA023074), Partnership for Native American Cancer Prevention (U54CA143924 and U54CA143925), and American Urological Association/Urology Care Foundation (Research Scholar Award).We thank the NCDB for RCC patients’ data. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic and statistical methodology. The contents of this article are solely the responsibility of the authors and do not necessary represent the official views of American College of Surgeons and Commission on Cancer.
Funding Information:
Funding: This study was supported by funding from National Cancer Institute (1R21CA248361-01, P30CA023074), Partnership for Native American Cancer Prevention (U54CA143924 and U54CA143925), and American Urological Association/Urology Care Foundation (Research Scholar Award).
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Racial/ethnic minority groups in the United States have high renal cell carcinoma (RCC) mortality rates. This study assessed surgical treatment disparities across racial/ethnic groups and impacts of neighborhood socioeconomic characteristics on surgical treatments and overall mortality. Stage I RCC patients diagnosed between 2004 and 2016 from National Cancer Database were included (n = 238,141). We assessed differences in associations between race/ethnicity and treatment patterns using logistic regression and between race/ethnicity and overall mortality using Cox regression with and without neighborhood characteristics in the regression models. When compared to non-Hispanic Whites (NHWs), American Indians/Alaska Natives and non-Hispanic Blacks (NHBs) were more likely not to receive surgical care and all racial/ethnic minority groups had significantly increased odds of undergoing radical rather than partial nephrectomy, even after adjusting for neighborhood characteristics. Including surgical treatment and neighborhood factors in the models slightly attenuated the association, but NHBs had a significantly increased risk of overall mortality. NHBs who underwent radical nephrectomy had an increased risk of mortality (HR 1.15, 95% CI: 1.08–1.23), but not for NHBs who underwent partial nephrectomy (HR 0.92, 95% CI: 0.84–1.02). Neighborhood factors were associated with surgical treatment patterns and overall mortality in both NHBs and NHWs. Neighborhood socioeconomic factors may only partly explain RCC disparities.
AB - Racial/ethnic minority groups in the United States have high renal cell carcinoma (RCC) mortality rates. This study assessed surgical treatment disparities across racial/ethnic groups and impacts of neighborhood socioeconomic characteristics on surgical treatments and overall mortality. Stage I RCC patients diagnosed between 2004 and 2016 from National Cancer Database were included (n = 238,141). We assessed differences in associations between race/ethnicity and treatment patterns using logistic regression and between race/ethnicity and overall mortality using Cox regression with and without neighborhood characteristics in the regression models. When compared to non-Hispanic Whites (NHWs), American Indians/Alaska Natives and non-Hispanic Blacks (NHBs) were more likely not to receive surgical care and all racial/ethnic minority groups had significantly increased odds of undergoing radical rather than partial nephrectomy, even after adjusting for neighborhood characteristics. Including surgical treatment and neighborhood factors in the models slightly attenuated the association, but NHBs had a significantly increased risk of overall mortality. NHBs who underwent radical nephrectomy had an increased risk of mortality (HR 1.15, 95% CI: 1.08–1.23), but not for NHBs who underwent partial nephrectomy (HR 0.92, 95% CI: 0.84–1.02). Neighborhood factors were associated with surgical treatment patterns and overall mortality in both NHBs and NHWs. Neighborhood socioeconomic factors may only partly explain RCC disparities.
KW - Cancer health disparities
KW - Geospatial
KW - Kidney cancer
KW - Neighborhood socioeconomic status
KW - Surgical disparities
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U2 - 10.3390/ijerph19042050
DO - 10.3390/ijerph19042050
M3 - Article
C2 - 35206240
AN - SCOPUS:85124338823
SN - 1661-7827
VL - 19
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 4
M1 - 2050
ER -