Racial and ethnic disparities in brain tumour survival by age group and tumour type

Abstract

Purpose

The extent to which racial/ethnic brain tumour survival disparities vary by age is not very clear. In this study, we assess racial/ethnic brain tumour survival disparities overall by age group and type.

Methods

Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 18 registries for US-based individuals diagnosed with a first primary malignant tumour from 2007 through 2016. Cox proportional hazards regression was used to compute adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between race/ethnicity and brain tumour survival, stratified by age group and tumour type.

Results

After adjusting for sex, socioeconomic status, insurance status, and tumour type, non-Hispanic (NH) Blacks (HR: 1.26; 95% CI: 1.02–1.55), NH Asian or Pacific Islanders (HR: 1.29; 95% CI: 1.01–1.66), and Hispanics (any race) (HR: 1.28; 95% CI: 1.09–1.51) all showed a survival disadvantage compared with NH Whites for the youngest age group studied (0–9 years). Furthermore, NH Blacks (HR: 0.88; 95% CI: 0.91–0.97), NH Asian or Pacific Islanders (HR: 0.84; 95% CI: 0.77–0.92), and Hispanics (any race) (HR: 0.91; 95% CI: 0.85–0.97) all showed a survival advantage compared with NH Whites for the 60–79 age group. Tests for interactions showed significant trends, indicating that racial/ethnic survival disparities disappear and even reverse for older age groups (P < 0.001). This reversal appears to be driven by poor glioblastoma survival among NH Whites (P < 0.001).

Conclusion

Disparities in brain tumour survival among minorities exist primarily among children and adolescents. NH White adults show worse survival than their minority counterparts, which is possibly driven by poor glioblastoma biology.

Keywords:

• Racial/ethnic disparities
• brain
• cancer
• survival
• age

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

Publicly available dataset.

Code availability

Statistical code available upon request.

Figure 1. Kaplan–Meier curve illustrating survival probabilities for adults and children/adolescents diagnosed with brain tumours from 2007 to 2016 by race/ethnicity over time in survival months.

Additional information

Notes on contributors

Arash Delavar

Arash Delavar, MPH is a medical student at UC San Diego; Arvin R. Wali, MD, MAS is a resident of neurological surgery at UC San Diego; David R. Santiago-Dieppa, MD is an assistant professor of neurological surgery at UC San Diego; Omar M. Al Jammal, BA is a medical student at UC San Diego; Reilly L. Kidwell, BS is a medical student at UC San Diego; Alexander A. Khalessi, MD, MBA is a professor and chair of neurological surgery at UC San Diego.