Racial disparities in nephrectomy and mortality among patients with renal cell carcinoma: Findings from SEER

Purpose To assess racial differences in the receipt of nephrectomy in patients diagnosed RCC in the US. Materials and Methods 2005 to 2015 data from the SEER database was analyzed and 70059 patients with RCC were identified. We compared demographic and tumor characteristics between Blacks and Whites. We applied logistic regression to assess the influence of race on 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. Results Overall, there was a relative increase in the use of nephrectomy from 2007 (p<0.0001). However, Blacks had 18% lower odds of receiving nephrectomy compared to Whites (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 Blacks and Whites, Blacks had 27% greater odds of all-cause mortality than Whites (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. Conclusions Blacks diagnosed with RCC in the US have a greater ACM risk and are less likely than Whites to receive nephrectomy. Systemic changes are needed to eliminate racial disparity in the treatment and outcomes of RCC in the US.