OBJECTIVE: To determine the rate of observation utilization over time and to identify factors influencing its use. MATERIALS AND METHODS: Using the National Cancer Data Base, we studied observation utilization in @entity1 diagnosed with @entity1358 from 2003 to 2010. Relationships between temporal, demographic, provider, and clinical factors and the likelihood of observation were evaluated using multivariate logistic regression. RESULTS: Of 109,410 analyzed @entity1 , 7047 (6.4%) underwent observation with stable use over time (range, 6.1% to 6.8%). @entity1 and disease factors were the strongest predictors of observation. Specifically, the odds of biopsy were 1.8-11 times higher for elderly or comorbid @entity1 and 1.6-8.4 times higher for small (clinical T1a), biopsied, or @entity5 (P <.01 for all). Racial and socioeconomic factors also significantly predicted observation usage. In particular, observation rates were higher among poor, African American, and uninsured or socially insured @entity1 , with these groups having 1.2-3.5 times higher odds of observation (P <.01). @entity1 receiving care at community, low-volume, or nearby hospitals were also significantly more likely to undergo observation (P <.01). CONCLUSION: Despite the continued rise in the incidence of incidental renal masses, initial observation use has remained stable. In accordance with treatment guidelines, observation is preferentially utilized in elderly and comorbid @entity1 . However, nonclinical factors also predict observation use, suggesting that utilization may be influenced by racial and socioeconomic disparities in health care quality.

Nonclinical Factors Predict Selection of Initial Observation for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Patient'] @entity1358 :: ('MESH:D002292', 'Disease') :: ['localized renal cell carcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['bilateral tumors']
@entity1358 :: (MESH:D002292,Disease) :: ['Renal Cell Carcinoma']
