Renal Cell Carcinoma Surgical Treatment Disparities in American Indian/Alaska Natives and Hispanic Americans in Arizona

Francine C. Gachupin, Benjamin R. Lee, Juan Chipollini, Kathryn R. Pulling, Alejandro Cruz, Ava C. Wong, Celina I. Valencia, Chiu-Hsieh Hsu and Ken Batai
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Francine C. Gachupin: Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA
Benjamin R. Lee: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
Juan Chipollini: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
Kathryn R. Pulling: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
Alejandro Cruz: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
Ava C. Wong: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
Celina I. Valencia: Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA
Chiu-Hsieh Hsu: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
Ken Batai: Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA

IJERPH, 2022, vol. 19, issue 3, 1-10

Abstract: American Indians/Alaska Natives (AI/AN) and Hispanic Americans (HA) have higher kidney cancer incidence and mortality rates compared to non-Hispanic Whites (NHW). Herein, we describe the disparity in renal cell carcinoma (RCC) surgical treatment for AI/AN and HA and the potential association with mortality in Arizona. A total of 5111 stage I RCC cases diagnosed between 2007 and 2016 from the Arizona Cancer Registry were included. Statistical analyses were performed to test the association of race/ethnicity with surgical treatment pattern and overall mortality, adjusting for patients’ demographic, healthcare access, and socioeconomic factors. AI/AN were diagnosed 6 years younger than NHW and were more likely to receive radical rather than partial nephrectomy (OR 1.49 95% CI: 1.07–2.07) compared to NHW. Mexican Americans had increased odds of not undergoing surgical treatment (OR 1.66, 95% CI: 1.08–2.53). Analysis showed that not undergoing surgical treatment and undergoing radical nephrectomy were 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). Mexican Americans, particularly U.S.-born Mexican Americans, had an increased risk for overall mortality and RCC-specific mortality even after adjusting for neighborhood socioeconomic factors and surgical treatment patterns. Although statistically not significant after adjusting for neighborhood-level socioeconomic factors and surgical treatment patterns, AI/AN had an elevated risk of mortality.

Keywords: kidney cancer; cancer health disparities; nephrectomy; surgical treatment; Arizona cancer (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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