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Glioma incidence and survival variation by county-level socioeconomic measures
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June 17 2019
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Source: Cancer. 125(19):3390-3400
[PDF-470.16 KB]
Details:
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Alternative Title:Cancer
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Personal Author:
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Description:Introduction:
Multiple studies have reported higher rates of glioma in areas with higher socioeconomic status (SES) but have not stratified by other factors, including race/ethnicity or urban versus rural location.
Methods:
We identified the average annual age-adjusted incidence rates and calculated hazard ratios for death for glioma of various subtypes, stratified by a county-level index for SES, race/ethnicity, US region, and rural/urban status.
Results:
Rates of glioma were highest in counties with higher SES (rate ratio=1.18, 95%CI=1.15-1.22 comparing highest to lowest quintiles, p<0.001). Stratified by race/ethnicity, higher rates in high SES counties persisted for White non-Hispanic individuals. Stratified by rural/urban status, differences in incidence by SES were more pronounced among urban counties. Survival was higher for residents of high SES counties after adjustment for age and extent of resection (HR=0.82, 95%CI=0.76-0.87 comparing highest to lowest quintile of SES, p<0.001). Survival was higher among White Hispanic, Black, and Asian or Pacific Islander individuals compared to White non-Hispanic individuals, after adjustment for age, SES, extent of resection, and when restricted to those with glioblastoma who received radiation and chemotherapy.
Conclusion:
Incidence of glioma was higher in US counties of high compared to low SES. These differences were most pronounced among White non-Hispanic individuals and White Hispanic individuals, in urban areas. We observed better survival in high SES counties, even when adjusting for extent of resection, and when restricting to those who received radiation and chemotherapy for glioblastoma. Differences in incidence and survival were associated with SES and race, rather than rural/urban status.
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Source:
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Pubmed ID:31206646
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Pubmed Central ID:PMC6744292
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Volume:125
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Issue:19
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