旨在评估美国按种族和民族划分的患者拒绝癌症手术决定的趋势。拒绝潜在治愈性癌症手术的种族和民族差异被认为是由于医疗保健获取方面的系统性不平等和对医疗保健系统的不信任等因素造成的。尽管全国范围内不断努力解决这些不平等问题，但癌症手术拒绝率的差异是否有所改善尚不清楚。利用 2000 年至 2019 年美国监测、流行病学和最终结果计划的人口数据，我们研究了患有非癌症的个体。癌症转移者，建议手术治疗。使用混合效应 Logistic 回归，按年份和癌症部位评估拒绝手术风险调整率的种族和民族差异。在 2,740,129 名可切除、非转移性癌症患者中，黑人患者拒绝手术率最高（2.10% [ 95% CI，1.91-2.31%]），而白人患者的比例最低（1.04% [95% CI，0.95-1.14%]）。从 2000 年到 2019 年，拒绝手术的种族和民族差异没有显着变化，除了西班牙裔和白人患者之间的差异有所下降（双重差异，-0.4% [95% CI，-0.71% 至 -0.09] %]）。按癌症部位分层时，十五个部位（食管、胰腺、肺和肾）中的四个部位（食管、胰腺、肺和肾）的黑人与白人拒绝手术率的差异显着下降（但并未消除）（P<0.001）。来自种族和族裔的患者不同群体更有可能拒绝对可能治愈的恶性肿瘤进行手术干预，而且这些差异随着时间的推移一直持续存在。需要进一步开展工作来了解这些差异的原因并找出改进的机会。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

To assess trends in patients' decisions to decline cancer surgery in the United States by race and ethnicity.Racial and ethnic differences in declining potentially curative cancer surgery are suggested to be due to systemic inequities in healthcare access and mistrust of healthcare systems, among other factors. Despite ongoing national efforts to address these inequities, it is unknown whether differences in rates of declined cancer surgery have improved.Using population-based data from the US Surveillance, Epidemiology, and End Results Program from 2000 to 2019, we studied individuals with non-metastatic cancer who were recommended surgery. Racial and ethnic differences in risk-adjusted rates of declined surgery were evaluated by year and cancer site using mixed-effects logistic regression.Of 2,740,129 patients with resectable, non-metastatic cancer, Black patients had the highest rates of declined surgery (2.10% [95% CI, 1.91-2.31%]) while White patients had the lowest (1.04% [95% CI, 0.95-1.14%]). From 2000 to 2019, racial and ethnic differences in declined surgery did not change significantly, except for a decrease in the difference between Hispanic and White patients (difference-in-difference, -0.4% [95% CI, -0.71% to -0.09%]). When stratified by cancer site, Black-White differences in rates of declined surgery decreased significantly (but were not eliminated) for four of fifteen sites (esophageal, pancreatic, lung, and kidney) (P<0.001).Patients from racial and ethnic minority groups were more likely to decline surgical intervention for potentially curable malignancies and these differences have persisted over time. Further work is needed to understand the causes of these differences and identify opportunities for improvement.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.