Current impact of ureteral carcinoma amongst racial minorities: Analysis of the National Cancer Database.

675 Background: Upper tract cancer is a relatively uncommon type of genitourinary cancer. Lower socioeconomic status and racial disparities have long been associated with worse cancer related outcomes for various types of cancer. Our objective was to determine if racial minorities in the United States were more likely to present with ureteral cancer of stage II or greater. Methods: The National Cancer Database (NCDB) Hospital Comparison Benchmark Reports (HCBR) for ureter cancer from 2013 to 2022 were reviewed. Demographic and clinical data was compared between various races and ethnicities affected to determine any significant differences related to age, stage, insurance status, distance traveled, and education at presentation. Patients were stratified into two groups of patients with stage II or greater and those with less than stage II ureteral cancer. Fischer’s exact test was used to compare the proportion of Caucasian patients with stage II or greater ureteral cancer against patients of other ethnicities. Statistical significance was defined as p<0.05. Results: Within the NCDB HCBR database, there were 26,153 patients with ureter carcinoma spanning 1,238 hospitals, with males comprising 16, 435 (62.8%) and females 9,718 (37.2%). Caucasian patients included most cases at 22,314 (86%), followed by African American patients 1,072 (4.17%), Hispanic patients 1,047 (4.08%), Asian and Pacific Islander patients 871 (3.39%), and Native American patients 73 (0.28%). Overall stage distribution included—0: 9,342 (36.38%); I: 3,711 (14.45%); II: 2,443 (9.51%); III: 2,724 (10.61%); IV: 3,636 (14.16%). A higher proportion of Asian and Pacific Islander patients were more likely to present with Stage II or greater ureteral cancer compared to Caucasian patients (43% vs 33.9%, p<0.001). Furthermore, Asian and Pacific Islander patients were more likely to present with invasive disease (73.6% vs 63.9%, p<0.001). A higher proportion of Asian and Pacific Islander patients were found to be uninsured or have Medicaid, be from a less educated household, and were less likely to travel longer distances for care when compared to Caucasian patients (all p<0.001). Regarding presenting at stage II or greater, there was no significant difference found when comparing Caucasian patients versus African American, Hispanic, or Native American patients. Conclusions: Asian and Pacific Islander patients were more likely to present with stage II or greater ureteral cancer compared to their Caucasian counterparts. Future directions exploring the factors affecting these at-risk groups is vital to properly redirecting resources and improving disparities.