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Article

Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics

by
Eduardo Quinonez-Zanabria
1,
Celina I. Valencia
2,
Waheed Asif
1,
Jiping Zeng
1,
Ava C. Wong
1,
Alejandro Cruz
1,
Juan Chipollini
1,
Benjamin R. Lee
1,
Francine C. Gachupin
3,
Chiu-Hsieh Hsu
4 and
Ken Batai
1,*
1
Department of Urology, University of Arizona, Tucson, AZ 85724, USA
2
University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, USA
3
Department of Family and Community Medicine, University of Arizona, Tucson, AZ 85724, USA
4
Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85724, USA
*
Author to whom correspondence should be addressed.
Healthcare 2021, 9(9), 1183; https://doi.org/10.3390/healthcare9091183
Submission received: 25 July 2021 / Revised: 3 September 2021 / Accepted: 5 September 2021 / Published: 8 September 2021
(This article belongs to the Special Issue Access and Healthcare for Disadvantaged Populations)
Versions Notes

Abstract

Racial/ethnic minority groups have a disproportionate burden of kidney cancer. The objective of this study was to assess if race/ethnicity was associated with a longer surgical wait time (SWT) and upstaging in the pre-COVID-19 pandemic time with a special focus on Hispanic Americans (HAs) and American Indian/Alaska Natives (AIs/ANs). Medical records of renal cell carcinoma (RCC) patients who underwent nephrectomy between 2010 and 2020 were retrospectively reviewed (n = 489). Patients with a prior cancer diagnosis were excluded. SWT was defined as the date of diagnostic imaging examination to date of nephrectomy. Out of a total of 363 patients included, 34.2% were HAs and 8.3% were AIs/ANs. While 49.2% of HA patients experienced a longer SWT (≥90 days), 36.1% of Non-Hispanic White (NHW) patients experienced a longer SWT. Longer SWT had no statistically significant impact on tumor characteristics. Patients with public insurance coverage had increased odds of longer SWT (OR 2.89, 95% CI: 1.53–5.45). Public insurance coverage represented 66.1% HA and 70.0% AIs/ANs compared to 56.7% in NHWs. Compared to NHWs, HAs had higher odds for longer SWT in patients with early-stage RCC (OR, 2.38; 95% CI: 1.25–4.53). HAs (OR 2.24, 95% CI: 1.07–4.66) and AIs/ANs (OR 3.79, 95% CI: 1.32–10.88) had greater odds of upstaging compared to NHWs. While a delay in surgical care for early-stage RCC is safe in a general population, it may negatively impact high-risk populations, such as HAs who have a prolonged SWT or choose active surveillance.
Keywords: cancer health disparities; Latinos; American Indians; surgical disparities cancer health disparities; Latinos; American Indians; surgical disparities

Share and Cite

MDPI and ACS Style

Quinonez-Zanabria, E.; Valencia, C.I.; Asif, W.; Zeng, J.; Wong, A.C.; Cruz, A.; Chipollini, J.; Lee, B.R.; Gachupin, F.C.; Hsu, C.-H.; et al. Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics. Healthcare 2021, 9, 1183. https://doi.org/10.3390/healthcare9091183

AMA Style

Quinonez-Zanabria E, Valencia CI, Asif W, Zeng J, Wong AC, Cruz A, Chipollini J, Lee BR, Gachupin FC, Hsu C-H, et al. Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics. Healthcare. 2021; 9(9):1183. https://doi.org/10.3390/healthcare9091183

Chicago/Turabian Style

Quinonez-Zanabria, Eduardo, Celina I. Valencia, Waheed Asif, Jiping Zeng, Ava C. Wong, Alejandro Cruz, Juan Chipollini, Benjamin R. Lee, Francine C. Gachupin, Chiu-Hsieh Hsu, and et al. 2021. "Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics" Healthcare 9, no. 9: 1183. https://doi.org/10.3390/healthcare9091183

APA Style

Quinonez-Zanabria, E., Valencia, C. I., Asif, W., Zeng, J., Wong, A. C., Cruz, A., Chipollini, J., Lee, B. R., Gachupin, F. C., Hsu, C.-H., & Batai, K. (2021). Racial and Ethnic Disparities in Preoperative Surgical Wait Time and Renal Cell Carcinoma Tumor Characteristics. Healthcare, 9(9), 1183. https://doi.org/10.3390/healthcare9091183

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