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. 2024 Feb;13(3):e7007.
doi: 10.1002/cam4.7007.

Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona

Celina I Valencia  1 , Patrick Wightman  2 , Kristin E Morrill  3 , Chiu-Hsieh Hsu  4 , Hina Arif-Tiwari  5 , Eric Kauffman  6 , Francine C Gachupin  1 , Juan Chipollini  7 , Benjamin R Lee  7 , David O Garcia  8 , Ken Batai  9
Affiliations

Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona

Celina I Valencia et al. Cancer Med. 2024 Feb.

Abstract

Background: Hispanics and American Indians (AI) have high kidney cancer incidence and mortality rates in Arizona. This study assessed: (1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, and (2) whether time to surgery, race and ethnicity, and SVI are associated with upstaging to pT3/pT4, disease-free survival (DFS), and overall survival (OS).

Methods: Arizona Cancer Registry (2009-2018) kidney and renal pelvis cases (n = 4592) were analyzed using logistic regression models to assess longer time to surgery and upstaging. Cox-regression hazard models were used to test DFS and OS.

Results: Hispanic and AI patients with T1 tumors had a longer time to surgery than non-Hispanic White patients (median time of 56, 55, and 45 days, respectively). Living in neighborhoods with high (≥75) overall SVI increased odds of a longer time to surgery for cT1a (OR 1.54, 95% CI: 1.02-2.31) and cT2 (OR 2.32, 95% CI: 1.13-4.73). Race and ethnicity were not associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3/pT4 (OR 1.95, 95% CI: 0.99-3.84). A longer time to surgery was associated with PFS (HR 1.52, 95% CI: 1.17-1.99) and OS (HR 1.63, 95% CI: 1.26-2.11). Among patients with cT2 tumor, living in high SVI neighborhoods was associated with worse OS (HR 1.66, 95% CI: 1.07-2.57).

Conclusions: High social vulnerability was associated with increased time to surgery and poor survival after surgery.

Keywords: cancer health disparities; neighborhood factors; renal cancer; social determinants of health; treatment disparities.

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Conflict of interest statement

Dr Garcia is a National Board member for the American Cancer Society Cancer Action Network (CAN). The work here does not represent the views of the ACS CAN, and is not directly related to this manuscript.

Figures

FIGURE 1
FIGURE 1
Social vulnerability index (SVI) of kidney cancer patients' residence by race and ethnicity.
FIGURE 2
FIGURE 2
Factors associated with the longer time to surgical treatment in adjusted models. (A) cT1a (≥50 vs. <51 days), (B) cT1b (≥41 vs. <41 days), (C) cT2 (≥27 vs. <27 days), and (D) cT3 (≥28 vs. <28 days).
FIGURE 3
FIGURE 3
Longer time to surgery is associated with disease‐free survival (A) and overall survival (B). The Cox regression models exclude patients without a clinical diagnosis date before the surgery.
FIGURE 4
FIGURE 4
Association between overall social vulnerability index (SVI) and disease‐free survival. The Cox regression models exclude patients without a clinical diagnosis date before the surgery.
FIGURE 5
FIGURE 5
Association between overall social vulnerability index (SVI) and overall survival. The Cox regression models exclude patients without a clinical diagnosis date before the surgery.
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References

    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73:17‐48. - PubMed
    1. Palumbo C, Pecoraro A, Knipper S, et al. Contemporary age‐adjusted incidence and mortality rates of renal cell carcinoma: analysis according to gender, race, stage, grade, and histology. Eur Urol Focus. 2021;7:644‐652. - PubMed
    1. Bukavina L, Bensalah K, Bray F, et al. Epidemiology of renal cell carcinoma: 2022 update. Eur Urol. 2022;82:529‐542. - PubMed
    1. Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow‐up†. Ann Oncol. 2019;30:706‐720. - PubMed
    1. Ljungberg B, Albiges L, Abu‐Ghanem Y, et al. European Association of Urology guidelines on renal cell carcinoma: the 2022 update. Eur Urol. 2022;82:399‐410. - PubMed

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