Treatment Delays in the Hispanic Population with Renal Cell Carcinoma: An Analysis of Over 150,000 Patients using the National Cancer Database.

Abstract

Purpose: Disparities have been documented in the outcomes of various cancers (lung, colorectal, breast) among the Hispanic population compared to non-Hispanic whites (NHWs). However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. This study aimed to investigate the disparities in 1) RCC presentation and 2) the time to treatment initiation (TTI) between Hispanic and NHW patients.

Patients & methods: We conducted a comparative analysis using National Cancer Database data from 2004-2020 to evaluate disparities in RCC presentation and TTI between Hispanic and NHW patients. To minimize inherent differences between the two groups, we utilized 1:1 greedy caliper propensity score matching.

Results: After PSM, 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 [OR] 1.28; 95% confidence interval [CI] 1.03, 1.60) and were more likely to experience delays in surgery (hazard ratio [HR] 1.08; 95% CI 1.01, 1.16; p=0.017) or any other treatment (HR 1.08; 95% CI 1.01, 1.16; p=0.022). Hispanic patients also received chemotherapy later (HR 1.49; 95% CI 1.05, 2.12; p=0.027).

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 NHWs, highlighting the need for targeted interventions to address these inequalities.