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Comparative Study
. 2025 Mar;36(3):265-273.
doi: 10.1007/s10552-024-01891-3. Epub 2024 Nov 8.

Prognosis impact and clinical findings in renal cancer patients: comparative analysis between public and private health coverage in a cross-sectional and multicenter context

Eduardo Barrera-Juarez  1   2 , Antonio Nassim Halun-Trevino  3 , Manuel Ruelas-Martinez  3   4 , Andres Madero-Frech  3   4 , Victor Camacho-Trejo  5 , Miguel Estrada-Bujanos  6 , David Bojorquez  5 , Jhonatan Uribe-Montoya  6 , Francisco Rodriguez-Covarrubias  7 , Cynthia Villarreal-Garza  3   8
Affiliations
Comparative Study

Prognosis impact and clinical findings in renal cancer patients: comparative analysis between public and private health coverage in a cross-sectional and multicenter context

Eduardo Barrera-Juarez et al. Cancer Causes Control. 2025 Mar.

Abstract

Purpose: Research on disparities in prognosis and clinical characteristics between public and private healthcare sectors in developing countries remains limited. The study aimed to determine whether patients with public health coverage (1) have a greater mean tumor size at diagnosis compared to those with private health coverage; (2) exhibit differences in clinical staging and TNM classification between groups; and (3) show variations in demographic, clinical characteristics, histopathological findings, and surgical approaches among cohorts.

Methods: A cross-sectional, multicenter study was conducted on 629 patients from both private and public healthcare sectors, all histologically confirmed and surgically treated for Renal Cell Carcinoma (RCC), between 2011 and 2021 in high-volume hospitals in Monterrey, Mexico. To compare variables between groups, we employed independent samples t-tests, Mann Whitney U nonparametric test, along with Pearson's chi-square test complemented by post hoc analyses.

Results: Mean tumor size in the public group was 1.9 cm greater than in the private group (7.39 vs. 5.51 cm, p < 0.001). Patients in the public sector more frequently presented with larger tumors, a higher prevalence of risk factors (excluding BMI and hypertension), advanced disease (OR 2.12, 95% CI 1.43-3.16, p < 0.001), presence of symptoms, elevated TNM, lymphovascular invasion and a lower prevalence of minimally invasive surgery. A male-to-female ratio of 2.6:1 was noted in the private coverage group.

Conclusions: This study highlights a notable association between public health coverage and a higher prevalence of advanced RCC, with tumors in private coverage patients being smaller yet larger than commonly reported. There is a crucial need to develop new health policies for early detection of renal cancer in developing countries.

Keywords: Advanced disease; Health disparities; Public coverage; Renal tumor; Tumor size.

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Conflict of interest statement

Declarations. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: This study was performed aligned with the principles of the Declaration of Helsinki. Ethics approval was granted by the Ethics and Research Committee of Hospital Metropolitano SSNL. (May 25th, 2023/No. HMBSSSNL 2023/956).

Figures

Fig. 1
Fig. 1
Asymptomatic and symptomatic patients in both health coverage groups
Fig. 2
Fig. 2
Surgical approaches between groups
See this image and copyright information in PMC

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