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.
Disclosure statement
The authors report there are no competing interests to declare.
Data availability statement
Publicly available dataset.
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.