# Racial and socioeconomic disparities from time of diagnosis to treatment for small renal masses

## TL;DR

The study finds that Black patients with small kidney tumors experience longer treatment delays compared to non-Hispanic White patients.

## Contribution

The novel contribution is identifying racial disparities in treatment delays for small renal masses, independent of socioeconomic factors.

## Key findings

- Black patients had significantly longer time to treatment initiation compared to non-Hispanic White patients.
- Treatment delays from initial imaging were more strongly linked to clinical factors like comorbidities and tumor size than race.

## Abstract

To investigate how patient‐specific factors, including race and socioeconomic status, impact time to treatment initiation (TTI) for patients with small renal masses (SRMs).

We retrospectively reviewed 275 patients with SRMs ≤ 4 cm at Atrium Health Carolinas Medical Center who underwent treatment for their renal mass. TTI was defined by the time between office visit (TTI‐OV) or between initial imaging (TTI‐Imaging) and procedure date. Statistical analysis was employed to determine patient‐specific factors associated with TTI.

We found that TTI was significantly associated with race as Black patients experienced longer TTI than non‐Hispanic White patients (OV: HR = 0.637, 95% CI [0.479–0.848], p = 0.0048; Imaging: HR = 0.541, 95% CI [0.402–0.727], p = 0.0002). TTI, however, was not significantly associated with socioeconomic status as defined by Area Deprivation Index, income or insurance status. TTI‐OV was also significantly associated with procedure year, and TTI‐Imaging was associated with procedure year, Charlson Comorbidity Index (CCI) and tumour size when first seen on imaging. On multivariable analysis, TTI‐Imaging was not independently associated with race (p = 0.1775), suggesting procedure year, CCI and tumour size are more significant predictors of TTI.

Black patients experienced a treatment delay from initial clinical presentation to procedure, but treatment delays from initial imaging identification to procedure may be tied more strongly to clinical factors.