Racial/ethnic, socioeconomic, and geographic survival disparities in adolescents and young adults with primary central nervous system tumors

Vidya Puthenpura, Maureen E. Canavan, Jenny N. Poynter, Michael Roth, Farzana D. Pashankar, Beth A. Jones, Asher M. Marks

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Disparities in survival by race/ethnicity, socioeconomic status (SES), and geography in adolescent and young adult (AYA) patients with central nervous system (CNS) tumors have not been well studied. Procedure: A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database was conducted for AYA patients diagnosed with primary CNS tumors. Adjusted hazard ratios (aHR) were calculated using a multivariate Cox proportional hazard model to evaluate the association between race/ethnicity, SES, rurality, and hazard of death. Results: All minority groups showed an increased hazard of death with greatest disparities in the high-grade glioma cohort. Lower SES was associated with an increased hazard of death in non-Hispanic White (NHW) patients (aHR 1.12; 95% confidence interval [CI] 1.01–1.24), non-Hispanic Black (NHB) patients (aHR 1.34; 95% CI 1.00–1.80), and patients aged 25–29 years (aHR 1.29; 95% CI 1.07–1.55). Mediation analysis showed an indirect effect of SES on the effect of race/ethnicity on the hazard of death only among NHB patients, with SES accounting for 33.7% of the association between NHB and hazard of death. Rurality was associated with an increased hazard of death for patients in the lowest SES tertile (aHR 1.31; 95% CI 1.08–1.59) and NHW patients (aHR 1.20; 95% CI 1.08–1.34). Conclusions: Patients identified as a racial/ethnic minority, patients with a lower SES, and patients residing in rural areas had an increased hazard of death. Further studies are needed to understand and address the biological, psychosocial, societal, and economic factors that impact AYA neuro-oncology patients at highest risk of experiencing poorer outcomes.

Original languageEnglish (US)
Article numbere28970
JournalPediatric Blood and Cancer
Volume68
Issue number7
Early online dateMar 11 2021
DOIs
StatePublished - Jul 2021

Bibliographical note

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Keywords

  • adolescent and young adults
  • central nervous system tumors
  • racial/ethnic disparities
  • socioeconomic disparities
  • survival disparities

PubMed: MeSH publication types

  • Journal Article

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