Burden of Renal Cysts Imaging: A Survey of Patients among the Greater Plains Collaborative

Abstract

<b><i>Purpose:</i></b> Renal cysts are a frequent incidental finding on cross-sectional radiographic imaging. While most cysts are indolent, individuals with such cysts are frequently monitored for interval growth and potential malignant transformation, which is ultimately rare. In this study, we aimed to assess patients’ values and preferences (believes and attitudes) about renal cysts. <b><i>Methods:</i></b> We deployed a cross-sectional survey to a random sample of patients with a diagnosis of renal cysts who were identified by billing code and self-identification. We collected data about demographics, insurance status, family history and overall health, and characteristics of patients with renal cysts. We performed a binary regression analysis (adjusted for age, gender, family history of cancer and kidney disease, and treatment plan for renal cysts) to determine anxiety predictors in patients with renal cysts. <b><i>Results:</i></b> We included 301 respondents in whom billing code and self-identification corresponded; of these, 138 had renal cysts and 163 did not. In an adjusted regression analysis, there was a suggestion that a clear management plan (OR = 0.49, 95% CI [0.22–1.11]) (<i>p</i> value 0.08) may be associated with less anxiety and a family history of renal disease may be associated with more anxiety (OR = 1.94 [0.76–4.94]) (<i>p</i> value 0.17). Family history of cancer also did not significantly predict anxiety (OR = 0.54 [0.24–1.19]) (<i>p</i> value 0.13). All these results were not statistically significant and had wide confidence intervals of the effect estimates make the results imprecise. <b><i>Conclusion:</i></b> Findings of this pilot study suggest a clear management plan for the renal cyst(s) management may be associated with a lower level of anxiety, thereby by emphasizing the importance of good communication, patient engagement and evidence-based guidance. More definitive, adequately powered studies are needed to evaluate this finding further. In addition, further studies exploring differences in imaging practices, patient symptomatology and patient engagement by different provider types would be insightful. Ultimately, tools to improve shared decision-making are needed to provide more patient-centered care.