Racial and socioeconomic disparities differentially affect overall and cause-specific survival in glioblastoma

Liu, Elisa K.; Yu, Sharon; Sulman, Erik P.; Kurz, Sylvia C.

doi:10.1007/s11060-020-03572-y

Cited by 24 publications

(27 citation statements)

References 38 publications

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“…13,20,[44][45][46][47][48] There could also be racial differences in the response to chemotherapeutics due to potential differences in pharmacogenomics and tumor molecular markers across the racial/ethnic groups. 49,50 However, there does not appear to be a documentation of race-based biological differences in these factors and the extent to which they impact treatment outcomes. 37 Future studies should specifically explore host and tumor genetic factors and its influence on treatment response across racial groups.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is evidence to suggest that racial discrimination on the part of health care providers, minority patients being less likely to be enrolled in clinical trials, and patients declining treatment options due to mistrust of the health system contribute to disparities in treatment 13,20,44–48 . There could also be racial differences in the response to chemotherapeutics due to potential differences in pharmacogenomics and tumor molecular markers across the racial/ethnic groups 49,50 . However, there does not appear to be a documentation of race‐based biological differences in these factors and the extent to which they impact treatment outcomes 37 .…”

Section: Discussionmentioning

confidence: 99%

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Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

Haizel-Cobbina

Spector

Moertel

et al. 2020

Pediatric Blood & Cancer

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Background: Despite improvements in overall survival for pediatric cancers, treatment disparities remain for racial/ethnic minorities compared to non-Hispanic Whites; however, the impact of race on treatment outcomes for pediatric brain and central nervous system (CNS) tumors in the United States is not well known. Methods: We included 8713 children aged 0-19 years with newly diagnosed primary brain and CNS tumors between 2000 and 2015 from the Census Tract-level SES and Rurality Database developed by Surveillance, Epidemiology, and End Results (SEER) Program. We used chi-square tests to assess differences in sociodemographic, cancer, and treatment characteristics by race/ethnicity and Kaplan-Meier curves and Cox proportional hazards models to examine differences in 10-year survival, adjusting for these characteristics. Results: Among 8713 patients, 56.75% were non-Hispanic White, 9.59% non-Hispanic Black, 25.46% Hispanic, and 8.19% from "other" racial/ethnic groups. Median unadjusted survival for all pediatric brain tumors was 53 months, but varied significantly by race/ethnicity with a median survival of 62 months for non-Hispanic Whites, 41 months for non-Hispanic Blacks, and 40 months for Hispanic and other. Multivariable analyses demonstrated minority racial groups still had significantly higher hazard of death than non-Hispanic Whites; Hispanic (adjusted hazard ratio [aHR] 1.25 [1.18-1.31]); non-Hispanic Black (aHR 1.12 [1.04-1.21]); other (aHR 1.22 [1.12-1.32]). Results were consistent when stratified by tumor histology. Conclusion: We identified disparities in survival among racial/ethnic minorities with pediatric brain and CNS tumors, with Hispanic patients having the highest risk of mortality. Eliminating these disparities requires commitment toward promoting heath equity and personalized cancer treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

Haizel-Cobbina

Spector

Moertel

et al. 2020

Pediatric Blood & Cancer

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“…In both developed and developing countries there are initiatives to raise public awareness of brain tumors, including the HeadSmart program in the United Kingdom ( 107 ). Access to emerging diagnostic (genomic platforms, DNA methylation profiling, advanced imaging) and therapeutic options (targeted and immunotherapies, PBT) remains limited to some developed countries or specific tertiary/quaternary pediatric or comprehensive cancer centers leading the vanguard in neuro-oncology ( 108 ). Moreover, it will be challenging for health care systems or third-party insurers in many countries to ensure equitable access to these recent and emerging clinical advances.…”

Section: Awareness Equity Diversity and Inclusivitymentioning

confidence: 99%

World Cancer Day 2021 - Perspectives in Pediatric and Adult Neuro-Oncology

Sulman

Eisenstat

2021

Front. Oncol.

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Significant advances in our understanding of the molecular genetics of pediatric and adult brain tumors and the resulting rapid expansion of clinical molecular neuropathology have led to improvements in diagnostic accuracy and identified new targets for therapy. Moreover, there have been major improvements in all facets of clinical care, including imaging, surgery, radiation and supportive care. In selected cohorts of patients, targeted and immunotherapies have resulted in improved patient outcomes. Furthermore, adaptations to clinical trial design have facilitated our study of new agents and other therapeutic innovations. However, considerable work remains to be done towards extending survival for all patients with primary brain tumors, especially children and adults with diffuse midline gliomas harboring Histone H3 K27 mutations and adults with isocitrate dehydrogenase (IDH) wild-type, O6 guanine DNA-methyltransferase gene (MGMT) promoter unmethylated high grade gliomas. In addition to improvements in therapy and care, access to the advances in technology, such as particle radiation or biologic therapy, neuroimaging and molecular diagnostics in both developing and developed countries is needed to improve the outcome of patients with brain tumors.

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“…Parsons et al found that patients with lower income were more likely to refuse local treatment in esophageal cancer, and Unger et al discovered that patients with lower income were less likely to participate in clinical trials 10,11 . In regard to outcomes, a study performed by Liu et al revealed that a lower median household income was associated with increased mortality in patients with glioblastoma multiforme 12 . Another study by Subramanian et al determined that patients with head and neck cancer enrolled in Medicaid due to poverty (meeting low‐income thresholds) were more likely to die within a year of diagnosis than their counterparts who qualified for Medicaid due to cash‐assistance 12,13 .…”

Section: Introductionmentioning

confidence: 99%

“…In regard to outcomes, a study performed by Liu et al revealed that a lower median household income was associated with increased mortality in patients with glioblastoma multiforme 12 . Another study by Subramanian et al determined that patients with head and neck cancer enrolled in Medicaid due to poverty (meeting low‐income thresholds) were more likely to die within a year of diagnosis than their counterparts who qualified for Medicaid due to cash‐assistance 12,13 . In patients with head and neck cancer, low income, low education, and advanced age have been shown to predict poor survival 14 .…”

Section: Introductionmentioning

confidence: 99%

Associations of insurance, urbanity, and comorbidity with types of palliative care received by patients with head and neck cancer

et al. 2021

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Background Our study examined some of the social and medical factors associated with receiving pain palliation alone over more aggressive cytoreductive palliative measures, such as surgery, chemotherapy, or radiation among patients with head and neck cancer. Methods This retrospective study used the National Cancer Database 2016 for data analysis. Patient and tumor characteristics were examined using bivariate analysis and logistic regression to identify their association with receiving pain palliation alone versus cytoreductive palliation treatment. Results Using multivariate logistic regression analysis, insurance status (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.15–0.50, p < 0.001), urbanity (OR: 1.73, 95%CI: 1.21–2.46, p = 0.002), and Charlson–Deyo scores greater than 3 (OR: 2.49, 95%CI: 1.38–4.47, p = 0.002) were significantly associated with receipt of pain palliation alone. Conclusions Clinicians should be aware of non‐health‐related factors, such as insurance status, that may influence patients' receipt of treatments in head and neck cancer.

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Racial and socioeconomic disparities differentially affect overall and cause-specific survival in glioblastoma

Cited by 24 publications

References 38 publications

Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States

World Cancer Day 2021 - Perspectives in Pediatric and Adult Neuro-Oncology

Associations of insurance, urbanity, and comorbidity with types of palliative care received by patients with head and neck cancer

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