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

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