Barriers to Health Care Access and Use Among Racial and Ethnic Minorities With Renal Cell Carcinoma

Racial disparities in renal cell carcinoma (RCC) outcomes are well documented, yet the specific patient-reported barriers contributing to these inequities remain underexamined. This study investigates the barriers to health care access on minority patients with RCC.

We performed a cross-sectional study using version 8 of the All of Us Research Program. RCC cases were identified using electronic health record data. We analyzed patient-reported data regarding financial barriers, social determinants, and health literacy. Comparisons between White, Hispanic, and Black patients were conducted using χ² tests and adjusted logistic regressions controlled for age, sex, education, insurance, and income.

Among 2215 patients with RCC, minority respondents were younger (P < .0001) and reported lower annual incomes (P < .0001). Hispanic patients more frequently cited inability to afford medications (23.8% vs 8.2% in White patients, P < .0001) and mental health service costs (12.6%, P = .026), whereas Black patients reported difficulty taking time off work (P = .0018) and transportation issues (P < .0001). In addition, 44.4% of both Black and Hispanic patients rated their general health as poor or fair, compared with 29.3% of White patients (P < .0001). In adjusted models, Black patients had twice the odds of being unable to afford medications (adjusted odds ratio 2.09 [1.20-3.65], P = .0096), and Hispanic patients were nearly 4 times more likely to delay care because of co-pays (adjusted odds ratio 3.98 [1.87-8.47], P = .00033).

Minority patients with RCC face significant structural and financial barriers, including cost-related delays and lower self-rated health, even after adjusting for socioeconomic status. Addressing these patient-reported obstacles is essential to achieving health equity in urologic oncology.