Ikuemonisan Joshua, Aremu Taiwo Opeyemi, Oyejinmi Isaac, Ajala Christopher, Anikpezie Nnabuchi, Akinso Oyindamola, Mtengwa Mutsa, David Adeyemo, Olokede Olugbenga, Adejoro Oluwakayode
Division of Tobacco Research and Prevention, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America.
Department of Pharmaceutical Care & Health Systems (PCHS), University of Minnesota, Minneapolis, Minnesota, United States of America.
PLOS Glob Public Health. 2023 May 23;3(5):e0001314. doi: 10.1371/journal.pgph.0001314. eCollection 2023.
To assess racial differences in the receipt of nephrectomy in patients diagnosed RCC in the US.
2005 to 2015 data from the SEER database was analyzed and 70,059 patients with RCC were identified. We compared demographic and tumor characteristics between black patients and white patients. We applied logistic regression to assess the association between race and the odds of the receipt of nephrectomy. We also applied Cox proportional hazards model to assess the impact of race on cancer-specific mortality (CSM) and all-cause mortality (ACM) in patients diagnosed with RCC in the US.
Black patients had 18% lower odds of receiving nephrectomy compared to white patients (p < 0.0001). The odds of the receipt of nephrectomy also reduced with age at diagnosis. In addition, patients with T3 stage had the greatest odds of receiving nephrectomy when compared to T1 (p < 0.0001). There was no difference in the risk of cancer-specific mortality between black patients and white patients; black patients had 27% greater odds of all-cause mortality than white patients (p < 0.0001). Patients who did not receive nephrectomy had a 42% and 35% higher risk of CSM and ACM respectively, when compared to patients who received nephrectomy.
Black patients diagnosed with RCC in the US have a greater ACM risk and are less likely than white patients to receive nephrectomy. Systemic changes are needed to eliminate racial disparity in the treatment and outcomes of RCC in the US.
评估美国确诊为肾细胞癌（RCC）的患者在接受肾切除术方面的种族差异。
分析2005年至2015年美国国立癌症研究所监测、流行病学和最终结果（SEER）数据库的数据，确定了70059例RCC患者。我们比较了黑人患者和白人患者的人口统计学和肿瘤特征。我们应用逻辑回归分析来评估种族与接受肾切除术几率之间的关联。我们还应用Cox比例风险模型来评估种族对美国确诊为RCC患者的癌症特异性死亡率（CSM）和全因死亡率（ACM）的影响。
与白人患者相比，黑人患者接受肾切除术的几率低18%（p<0.0001）。接受肾切除术的几率也随着诊断时的年龄增加而降低。此外，与T1期患者相比，T3期患者接受肾切除术的几率最高（p<0.0001）。黑人患者和白人患者的癌症特异性死亡率没有差异；黑人患者的全因死亡率比白人患者高27%（p<0.0001）。与接受肾切除术的患者相比，未接受肾切除术的患者CSM和ACM风险分别高42%和35%。
在美国，被诊断为RCC的黑人患者ACM风险更高，且比白人患者接受肾切除术的可能性更小。需要进行系统性变革以消除美国RCC治疗和结局方面的种族差异。
