Dr. Woldu on disparities in advanced renal cell carcinoma

In this video, Solomon L. Woldu, MD, shares findings on disparities in advanced renal cell carcinoma (RCC) from the study “Socioeconomic and demographic disparities in immunotherapy for advanced clear cell renal cell carcinoma”, which were presented at the 2023 Society of Urologic Oncology Annual Meeting in Washington DC. Woldu is an assistant professor of urology at the University of Texas Southwestern Medical Center in Dallas, Texas.

Video Transcript:

When we think of disparities, our minds naturally gravitate towards the role of race and ethnicity and their [effect] on health care results in kidney cancer or other cancers or even other medical conditions. But the reality is that the causes of disparity can be many different things, including economics, education, religion, language barriers, and of course payer mix, especially in the United States. So, there are numerous disparities with regards to outcomes in RCC and kidney cancer. Some of the most prominent disparities are findings that suggest that African American and Hispanic patients have worse overall survival in a general aggregate way. I think that is certainly been borne out in the evidence, using large national level databases, such as the NCDB and SEER, but I think that in some ways, there's a problem with these large aggregate generalizations in the sense that we may lose the ability to actually have some action upon that. Instead, I think there's some value to focusing on discrete things that we can control as urologists as frontline workers.

One of the findings that we had in our study that we presented at this SUO meeting, is to look at the National Cancer Database, since the approval of immune checkpoint inhibition. In the study, when taking into account other factors, such as the socioeconomic factors that are available to us in the NCDB, we find that African American and Hispanic patients are about 20% less likely to receive immune checkpoint inhibition for advanced RCC. I think this this type of information could be very actionable to any frontline worker and provider, especially a group of urologists at this meeting who are seeing patients postoperatively and may be able to spend the extra time to counsel a patient towards, for instance, adjuvant immunotherapy for high-risk clear cell RCC.

This transcription has been edited for clarity.