Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona
Abstract 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 surger...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.7007 |
| _version_ | 1797216987946942464 |
|---|---|
| author | Celina I. Valencia Patrick Wightman Kristin E. Morrill Chiu‐Hsieh Hsu Hina Arif‐Tiwari Eric Kauffman Francine C. Gachupin Juan Chipollini Benjamin R. Lee David O. Garcia Ken Batai |
| author_facet | Celina I. Valencia Patrick Wightman Kristin E. Morrill Chiu‐Hsieh Hsu Hina Arif‐Tiwari Eric Kauffman Francine C. Gachupin Juan Chipollini Benjamin R. Lee David O. Garcia Ken Batai |
| author_sort | Celina I. Valencia |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-07T15:43:49Z |
| format | Article |
| id | doaj.art-a80df51aa0384194be4228d78bf2cf6b |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-24T11:54:42Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-a80df51aa0384194be4228d78bf2cf6b2024-04-09T05:45:47ZengWileyCancer Medicine2045-76342024-02-01133n/an/a10.1002/cam4.7007Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in ArizonaCelina I. Valencia0Patrick Wightman1Kristin E. Morrill2Chiu‐Hsieh Hsu3Hina Arif‐Tiwari4Eric Kauffman5Francine C. Gachupin6Juan Chipollini7Benjamin R. Lee8David O. Garcia9Ken Batai10Department of Family and Community Medicine, College of Medicine – Tucson The University of Arizona Tucson Arizona USACenter for Population Health Sciences The University of Arizona Tucson Arizona USACommunity and Systems Health Science Division, College of Nursing The University of Arizona Tucson Arizona USADepartment of Epidemiology and Biostatistics The University of Arizona Tucson Arizona USADepartment of Medical Imaging The University of Arizona Tucson Arizona USADepartment of Urology Roswell Park Comprehensive Cancer Center Buffalo New York USADepartment of Family and Community Medicine, College of Medicine – Tucson The University of Arizona Tucson Arizona USADepartment of Urology The University of Arizona Tucson Arizona USADepartment of Urology The University of Arizona Tucson Arizona USADepartment of Health Promotion Sciences The University of Arizona Tucson Arizona USADepartment of Cancer Prevention and Control Roswell Park Comprehensive Cancer Center Buffalo New York USAAbstract 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.https://doi.org/10.1002/cam4.7007cancer health disparitiesneighborhood factorsrenal cancersocial determinants of healthtreatment disparities |
| spellingShingle | Celina I. Valencia Patrick Wightman Kristin E. Morrill Chiu‐Hsieh Hsu Hina Arif‐Tiwari Eric Kauffman Francine C. Gachupin Juan Chipollini Benjamin R. Lee David O. Garcia Ken Batai Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona Cancer Medicine cancer health disparities neighborhood factors renal cancer social determinants of health treatment disparities |
| title | Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona |
| title_full | Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona |
| title_fullStr | Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona |
| title_full_unstemmed | Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona |
| title_short | Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona |
| title_sort | neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in arizona |
| topic | cancer health disparities neighborhood factors renal cancer social determinants of health treatment disparities |
| url | https://doi.org/10.1002/cam4.7007 |
| work_keys_str_mv | AT celinaivalencia neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT patrickwightman neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT kristinemorrill neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT chiuhsiehhsu neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT hinaariftiwari neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT erickauffman neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT francinecgachupin neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT juanchipollini neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT benjaminrlee neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT davidogarcia neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona AT kenbatai neighborhoodsocialvulnerabilityanddisparitiesintimetokidneycancersurgicaltreatmentandsurvivalinarizona |