title: Impact of multiple deprivations on detection, progression and interventions in small renal masses (less than 4 cm) in a population based study.
abstract: OBJECTIVE
  A relatively unknown associations exists between the detection, progression and rate of interventions in small renal masses in the context of socioeconomic status. The study explored the impact of socioeconomic status on the detection, progression and intervention rate in SRMs.
  
  
  METHODS
  A population-based cohort of patients with SRMs was identified using various hospital databases in well-defined geographical area between January 2007 and December 2011. A list of patients with unique 10-digits Community Health Index (CHI) number and their follow-up was recorded on a pre-designed electronic database sheet. Correlation between the socioeconomic status and detection, progression and pattern of interventions of small renal masses was the primary outcome. The postcode of each patient was identified and linked to the Scottish Index of Multiple Deprivation (SIMD) scoring system, and a deprivation category number assigned to each patient, allowing potential links to become apparent between small renal masses and deprivation.
  
  
  RESULTS
  Two hundred and seventeen patients were diagnosed with small renal masses in 150,820 abdominal imaging carried out in a population of 117,600. The detection of SRMs in relation to SIMD status showed no statistically significant differences across different categories. Similarly, interventions, type of surgery and progression remained unaffected by socioeconomic status. The group on active surveillance showed slow or no-growth at a mean follow-up of more than 2 years.
  
  
  CONCLUSIONS
  The detection of small renal masses is very small compared with the amount of imaging investigations of abdomen in 5 years in this cohort. Detection, progression and rate of intervention did not differ in different socioeconomic strata of the cohort. The majority of small renal masses on active surveillance did not change or grew in size very slowly when observed over time.
authors.affiliation: Academic Section of Urology, Medical Research Institute, Ninewells Hospital and Medical School, Ninewells Hospital, Dundee, Scotland, UK.
authors.forename: M
authors.initials: M
authors.lastname: Leonard
authors.forename: C D
authors.initials: CD
authors.lastname: Tait
authors.forename: A S
authors.initials: AS
authors.lastname: Gillan
authors.forename: B P
authors.initials: BP
authors.lastname: Rai
authors.forename: D J
authors.initials: DJ
authors.lastname: Byrne
authors.forename: G
authors.initials: G
authors.lastname: Nabi
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003952:Diagnostic Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D011159:Population Surveillance; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors
keywords: Renal cancer; Small renal masses; Socioeconomic status