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

Autor: Valencia CI; Department of Family and Community Medicine, College of Medicine - Tucson, The University of Arizona, Tucson, Arizona, USA., Wightman P; Center for Population Health Sciences, The University of Arizona, Tucson, Arizona, USA., Morrill KE; Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona, USA., Hsu CH; Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, USA., Arif-Tiwari H; Department of Medical Imaging, The University of Arizona, Tucson, Arizona, USA., Kauffman E; Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA., Gachupin FC; Department of Family and Community Medicine, College of Medicine - Tucson, The University of Arizona, Tucson, Arizona, USA., Chipollini J; Department of Urology, The University of Arizona, Tucson, Arizona, USA., Lee BR; Department of Urology, The University of Arizona, Tucson, Arizona, USA., Garcia DO; Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, USA., Batai K; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Feb; Vol. 13 (3), pp. e7007.
DOI: 10.1002/cam4.7007
Abstrakt: 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.
(© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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