Inequality in Kidney Cancer Treatment Affects Decision-Making

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The risk for under- or over-treatment for kidney cancer may be higher in women, in addition to Black and Hispanic patients.

Demographic factors including sex, race/ethnicity and insurance status may influence whether a patient is under- or overtreated for localized kidney cancer, according to a study.

“Despite the increasing attention devoted to overtreatment of indolent malignant tumors in urologic oncology, many patients with aggressive disease are undertreated, particularly members of racial/ethnic minority groups,” the study authors wrote.

Kidney cancer is among the 10 most common cancers in both men and women, according to the American Cancer Society. Black patients are twice as likely to have kidney cancer compared with other patients. Overall, it is predicted that there will be about 76,080 (48,780 men and 27,300 women) new cases of kidney cancer diagnosed in 2021.

Researchers used data collected between 2010 and 2017 to assess whether patients received non-guideline-based treatment for kidney cancer.

“We sought to assess the association between demographic factors (including sex, race/ethnicity and insurance status) and receipt of non-guideline–based kidney cancer treatmentin a comparatively young and healthy (group) of patients with localized kidney cancer and low competing risk of mortality,” the study authors wrote.

Among the 158,445 patients (median age, 58 years) with kidney cancer enrolled in the study, 62.8% were men, 75.7% were White and 57.6% had private insurance. In addition, 30.6% of patients received non-guideline-based treatment.

Compared with men, women were less likely to be undertreated for kidney cancer and more likely to be overtreated. Black and Hispanic patients were more likely to be undertreated and overtreated for kidney cancer compared with White patients.

Patients without insurance were more likely to be undertreated and less likely to be overtreated for kidney cancer compared with patients who had insurance.

“Clinicians should bear these disparities in mind when counseling individual patients, and health policy makers should take the existence of these disparities into account,” the study authors wrote.

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