A study of patients in New York City showed that higher socioeconomic status (SES) is associated with a greater likelihood of undergoing partial nephrectomy (PN) for localized renal masses, and the effect of SES varies by race.
As neighborhood SES quartile increased, White patients were significantly more likely to undergo PN, whereas Black patients were not.
Using the New York State Cancer Registry (NYSCAPED), a team led by Christopher B. Anderson, MD, MPH, of Columbia University Irving Medical Center in New York, New York, identified 5633 patients who underwent PN (61%) or radical nephrectomy (RN, 39%) for localized renal masses from 2004 to 2016. They identified patients’ home neighborhoods through Public Use Microdata Areas in NYSCAPED, which uses US Census-level socioeconomic and demographic data.
A significantly higher proportion of White patients than Black patients received PN (64.7% vs 57.4%), Dr Anderson and colleagues reported in Urologic Oncology. Compared with White patients, Black patients had significant 34% lower odds of undergoing PN. Compared with White patients in the lowest SES quartile (reference), White patients in the highest quartile had significant 1.2-fold higher odds of PN, whereas Black patients in the lowest and highest SES quartiles had significant 29% and 42% lower odds of PN, the investigators reported.
Within the highest neighborhood SES quartile, Black patients had significant 56% lower odds of receiving PN compared with White patients. In the other quartiles, the races did not differ significantly in the odds of PN, according to the investigators.
The authors acknowledged that their study had limitations. The New York State Cancer Registry database does not describe tumor location in the kidney or patients’ comorbid conditions. In addition, the database does not include information on the location and specific details about the treating hospitals.
Dr Anderson and colleagues pointed out that guidelines support PN as the preferred treatment for small localized renal masses when technically feasible because it offers similar oncologic outcomes to RN but with a lower risk for chronic kidney disease. Despite increasing use of PN for these renal masses, however, many patients who are eligible for PN but receive RN instead are disproportionately patients of color and those with low SES, they noted.
Wallace BK, Miles CH, Anderson CB. Effects of race and socioeconomic status in treatment for localized renal masses in New York City. Urol Oncol. Published online December 6, 2021. doi:10.1016/j.urolonc.2021.11.004