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Race and Cancer Surgery: Are Post-Op Complications Fair?

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"Unpacking the Complex Link Between Race, Complications, and Urologic Cancer Surgery Outcomes."

Racial disparities in healthcare have long been a concern, and the field of urologic oncology is no exception. A recent study published in the journal Urologic Oncology sheds light on this critical issue, examining the potential link between race and postoperative complications following major urologic cancer surgeries. The research, which analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), offers valuable insights into the complexities of patient outcomes.

The study's core question revolved around whether African American (AA) patients faced a higher risk of complications after procedures like radical prostatectomy, radical or partial nephrectomy, and radical cystectomy compared to their white counterparts. The findings, while nuanced, present a crucial starting point for a more in-depth examination of the factors that contribute to surgical outcomes.

This article breaks down the study's methodology, key findings, and implications, focusing on the factors driving these outcomes. It also underscores the importance of understanding these disparities to improve patient care, promote health equity, and ensure that all individuals receive the best possible treatment and support during their cancer journeys.

What Did the Study Discover About Race and Surgical Outcomes?

A diverse group of people walking toward a brightly lit hospital entrance, symbolizing hope and equitable healthcare.

The researchers analyzed data from nearly 39,000 patients who underwent urologic cancer surgeries between 2005 and 2013. Of this large cohort, 90% were white, and 10% were AA. The study's primary aim was to assess whether AA patients experienced higher rates of postoperative complications. The complications were categorized into minor (Clavien I–II), major (Clavien III–IV), and death (Clavien V), to evaluate the severity of the outcomes.

The initial findings were somewhat surprising. In the unadjusted analysis, the study found no significant differences in complication rates between AA and white patients for the procedures examined. However, the researchers knew that the AA patients often had more health problems, such as diabetes or high blood pressure. The next step was to see what would happen when they accounted for those health issues.

Comorbidity Burden: The study found that AA patients, on average, had a higher comorbidity burden than their white counterparts.
Adjusted Analysis: When the researchers adjusted for these differences in health status, the connection between race and complications went away.
Key Finding: Race did not independently predict the risk of postoperative complications. Instead, the presence of other health problems was a better predictor.

The study’s results are important because they suggest that the differences in outcomes aren’t necessarily due to race itself. Rather, the study indicates the importance of addressing the underlying medical conditions that may make surgery more risky. This highlights the need for a more holistic approach to patient care, focusing on both the surgery and the overall health of the individual.

Moving Forward: What Does This Mean for Patients?

The study's findings provide valuable insights for patients, clinicians, and healthcare systems. For patients, this research underscores the importance of open communication with their healthcare providers about their overall health and any existing medical conditions. For clinicians, it highlights the need for comprehensive preoperative assessments and proactive management of comorbidities to reduce the risk of complications. Healthcare systems can use this information to develop targeted interventions and programs to improve access to care and health outcomes for all patients, regardless of race or background. By addressing the root causes of disparities and focusing on patient-centered care, we can work towards a healthcare system that ensures equitable outcomes for everyone.

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Everything You Need To Know

What was the primary objective of the study examining race and urologic cancer surgeries?

The study aimed to investigate whether African American (AA) patients experienced a higher risk of postoperative complications after undergoing major urologic cancer surgeries, such as radical prostatectomy, radical or partial nephrectomy, and radical cystectomy, compared to white patients. The research analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to understand the relationship between race and surgical outcomes. It sought to determine if racial disparities existed and, if so, to explore potential factors contributing to these differences, such as comorbidity burden. The ultimate goal was to identify ways to improve patient care and promote health equity within urologic oncology. The study's focus was not to merely observe differences but to dissect and understand the reasons behind any observed disparities in surgical outcomes.

What were the main findings regarding race and postoperative complications in urologic cancer surgeries?

Initially, the unadjusted analysis of the study found no significant differences in complication rates between African American (AA) and white patients who underwent urologic cancer surgeries. However, after adjusting for differences in health status, specifically the comorbidity burden, the connection between race and complications diminished. The key finding was that race, by itself, did not independently predict the risk of postoperative complications. Instead, the presence of other health problems was a stronger predictor of complications, suggesting that addressing underlying medical conditions is crucial for improving surgical outcomes. This implies that focusing on comprehensive patient health management, rather than race alone, is vital for reducing postoperative risks. This does not mean race is irrelevant but rather that its impact is mediated by other health factors.

How did the study account for differences in health status between African American and white patients?

The study recognized that African American (AA) patients often had a higher comorbidity burden, meaning they had more pre-existing health problems like diabetes or high blood pressure, compared to their white counterparts. To account for these differences, the researchers performed an adjusted analysis. This involved statistically controlling for the impact of comorbidities on postoperative complications. By factoring in these pre-existing health conditions, the researchers could isolate the independent effect of race on surgical outcomes. The adjustment revealed that once comorbidities were considered, race was no longer a significant predictor of complications, highlighting the importance of addressing underlying health issues in preoperative care.

What is the significance of the study's findings for patients undergoing urologic cancer surgery?

The findings emphasize the critical importance of open communication between patients and their healthcare providers about their overall health and any existing medical conditions. Patients should proactively discuss all health issues, as these comorbidities can significantly impact surgical outcomes. Clinicians are encouraged to conduct comprehensive preoperative assessments to identify and manage comorbidities proactively. Healthcare systems can leverage this information to develop targeted interventions and programs aimed at improving access to care and enhancing health outcomes for all patients, regardless of race or background. The study underscores the need for a patient-centered approach that addresses not only the surgical procedure but also the patient's overall health and well-being. Ultimately, this leads to more equitable and improved surgical outcomes for everyone.

What implications do the results have for addressing healthcare disparities in urologic oncology?

The study suggests that addressing healthcare disparities in urologic oncology requires a focus on managing and mitigating the impact of comorbidities rather than solely focusing on race. This means implementing comprehensive preoperative assessments to identify underlying health conditions, such as diabetes and hypertension, that disproportionately affect African American (AA) patients. Healthcare systems should invest in resources and programs that improve access to quality healthcare and promote proactive health management within these communities. By addressing the root causes of disparities through targeted interventions, clinicians and healthcare providers can work towards a more equitable system that ensures all patients receive the best possible treatment and support, ultimately leading to improved surgical outcomes and reduced healthcare disparities.