Abstract 3635: Racial-ethnic comparisons in surgical treatment and outcomes of non-metastatic renal cell cancer in an equal access system

Background: Access to care has been implicated in racial-ethnic disparities in surgical treatment and survival for patients with renal cell carcinoma (RCC) in the United States. We assessed whether there were racial-ethnic disparities in surgery receipt and clinical outcomes of RCC in the U.S. Military Health System (MHS), which provides equal access to care for beneficiaries. Materials and Methods: We used the MilCanEpi database to study a cohort of patients aged 18 and older who were diagnosed with stage I-III RCC between 1998 and 2014. Treatment with nephrectomy was evaluated in logistic regression models expressed as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Risk of recurrence and all-cause death were estimated using multivariable Cox regression models. Results: The study included 1,371 non-Hispanic White, 362 non-Hispanic Black, and 177 Hispanic patients. Black patients were less likely to receive nephrectomy as non-Hispanic White patients overall (AOR=0.69, 95% CI=0.47, 1.00) and in strata for stage I (AOR=0.62, 95% CI=0.41, 0.95) or clear cell subtype (AOR=0.46, 95% CI=0.22, 0.96). Hispanic patients were as likely to receive nephrectomy as non-Hispanic White patients overall (AOR=1.13, 95% CI=0.49, 2.62) and in strata by stage or histologic subtype. There were no statistically significant differences in risk of recurrence or all-cause death for Black or Hispanic patients compared to non-Hispanic White patients in multivariable models. Conclusion: In the equal access MHS, nephrectomy receipt was similar for Hispanic patients compared to non-Hispanic White patients while Black patients, especially with stage I or clear cell RCC, were less likely to receive nephrectomy. Nevertheless, there were no differences in recurrence or survival for non-Hispanic Black or Hispanic patients compared to non-Hispanic White patients with non-metastatic RCC. Further research on factors other than access to care that may explain the lower likelihood of receiving nephrectomy for Black patients is needed. Citation Format: Yvonne L. Eaglehouse, Sarah Darmon, Craig D. Shriver, Kangmin Zhu. Racial-ethnic comparisons in surgical treatment and outcomes of non-metastatic renal cell cancer in an equal access system [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3635.