(UroToday.com) The 2025 South Central AUA annual meeting included a session on kidney cancer, featuring a presentation from Dr. Vedant Agrawal discussing patient-reported barriers, social determinants, and racial disparities in renal cell carcinoma (RCC). Racial disparities in RCC outcomes remain pronounced among Black and Hispanic patients, who often experience delayed diagnosis, fewer partial nephrectomies, and limited access to recommended therapies. The impact of patient‐reported barriers—particularly regarding healthcare access, social determinants, and perceived health status—on these inequities remains under examined.
This was a cross-sectional study using version 8 of the All of Us Research Program (2018-2023), and participants with RCC (identified via ICD-9, ICD-10, or SNOMED CT codes) were included. Demographics (age, sex at birth, income, insurance, education) were extracted from the Basics survey. Three supplemental surveys—Healthcare Access & Utilization, Social Determinants of Health, and Overall Health—provided information on financial barriers, discrimination in clinical settings, and self‐rated health and health literacy. Between‐group comparisons for Non‐Hispanic White, Hispanic/Latino, and Black or African American patients were conducted via chi‐square tests. Multivariable logistic regression controlled for age, sex, education, insurance, and income.
Among 2,215 RCC patients identified, 2,215 (100%) completed the Overall Health Survey, 1,207 (54.5%) completed the Healthcare Access & Utilization survey, and 945 (42.6%) completed the Social Determinants of Health survey. Minority respondents were younger (p < 0.0001) and reported lower annual incomes (p < 0.0001). In the Healthcare Access & Utilization survey, compared to Whites, Hispanic and Black patients more frequently cited “Can’t Afford Medications” (8.2% versus 18.8%, 23.8%, p < 0.0001) and worry about costs of illness (32.3% versus 60.7%, 46.2%, p = 0.026). From the Social Determinants of Health survey, Black patients were more likely more likely to report that they received poorer service than White and Hispanic patients (50.8% versus 36.0%, 38.8%, p < 0.0001). The Overall Health survey showed that 44.4% of Hispanic and 48.8% of Black respondents rated their general health as poor or fair, compared with 29% of Whites (p < 0.0001). Minority participants also reported more difficulty with health materials. In multivariable models, compared to Whites, Black patients had twice the odds of being unable to afford medications (adjusted OR 2.09, 95% 1.20–3.65, p = 0.0096), and Hispanic patients were nearly four times more likely to delay care due to co‐pay (3.98, 95% 1.87–8.47, p = 0.00033).
Dr. Agrawal concluded this presentation discussing patient-reported barriers, social determinants, and racial disparities in RCC with the following take-home points:
- In this large RCC cohort, minority participants reported more cost-related barriers, perceived discrimination, and lower self‐rated health, suggesting these patient‐reported obstacles may exacerbate known outcome disparities
- Interventions focusing on health information communication and financial aid could help contribute to improved outcomes
Presented by: Vedant Agrawal, John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 South Central American Urological Association (AUA) Annual Meeting, Orlando, FL, Wed, Sept 10 – Sat, Sept 13, 2025.