Victor M Lu1,2, Ashish H Shah3, Daniel G Eichberg3, Alfredo Quinones-Hinojosa4, Yoshua Esquenazi5, Ricardo J Komotar3, Michael E Ivan3. 1. Department of Neurological Surgery, Lois Pope Life Center, University of Miami Miller School of Medicine, Jackson Health System, Miami, FL, USA. lu.victor@mayo.edu. 2. Department of Neurologic Surgery, 200 First St. SW, Rochester, MN, 55905, USA. lu.victor@mayo.edu. 3. Department of Neurological Surgery, Lois Pope Life Center, University of Miami Miller School of Medicine, Jackson Health System, Miami, FL, USA. 4. Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA. 5. Vivian L. Smith Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Abstract
BACKGROUND: Access to treatment for glioblastoma (GBM) can be impacted by multiple demographic parameters. Barriers specific to the Hispanic population of the United States (US) are not fully understood. Therefore, the aim of this study was to elucidate geographic disparities for access to GBM treatment in the US Hispanic population. METHODS: All GBM patients with known Hispanic ethnicity status (and Caucasian race) in the US National Cancer Database (NCDB) between the years 2005-2016 were retrospectively reviewed. Treatment statuses of surgical resection, chemotherapy, radiation therapy and triple therapy (resection, chemotherapy and radiation) were summarized, and analyzed by comparison and regression analyses over US Census regions. RESULTS: A total cohort size of 40,232 Caucasian GBM patients were included, with 3,111 (8%) identifying as Hispanic. The odds of treatment by chemotherapy (OR 0.78, P < 0.01), radiation therapy (OR 0.82, P < 0.01) and triple therapy (OR 0.84, P < 0.01) were all significantly lower in the Hispanic group versus non-Hispanic group. The odds of being treated in the Hispanic group were significantly lower in multiple Census regions with respect to surgical resection (New England, OR 0.51; Mountain, OR 0.68), chemotherapy (East North Central, OR 0.77; Middle Atlantic, OR 0.71; Pacific, OR 0.77), radiation therapy (Middle Atlantic, OR 0.77) and triple therapy (New England, OR 0.49; Middle Atlantic, OR 0.87; Pacific, OR 0.84). Significant barriers to triple therapy in the Hispanic group within these regions were older age (OR 0.97; P < 0.01), treatment in a community facility (OR 0.85, P = 0.03), lack of insurance (OR 0.71, P = 0.03), yearly income < $40,227 (OR 0.69, P < 0.01), low education levels (OR 0.75, P = 0.03) and presence of co-morbidity (OR 0.82; P < 0.01). CONCLUSIONS: Currently in the US, there exists heterogenous geographic disparities for Hispanic GBM patients to access different treatments compared to non-Hispanic patients. Multiple circumstances can influence access to treatment within the Hispanic community of these regions, and greater investigation with more granularity required to reveal mechanisms in which these disparities may be addressed in the future.
BACKGROUND: Access to treatment for glioblastoma (GBM) can be impacted by multiple demographic parameters. Barriers specific to the Hispanic population of the United States (US) are not fully understood. Therefore, the aim of this study was to elucidate geographic disparities for access to GBM treatment in the US Hispanic population. METHODS: All GBMpatients with known Hispanic ethnicity status (and Caucasian race) in the US National Cancer Database (NCDB) between the years 2005-2016 were retrospectively reviewed. Treatment statuses of surgical resection, chemotherapy, radiation therapy and triple therapy (resection, chemotherapy and radiation) were summarized, and analyzed by comparison and regression analyses over US Census regions. RESULTS: A total cohort size of 40,232 Caucasian GBMpatients were included, with 3,111 (8%) identifying as Hispanic. The odds of treatment by chemotherapy (OR 0.78, P < 0.01), radiation therapy (OR 0.82, P < 0.01) and triple therapy (OR 0.84, P < 0.01) were all significantly lower in the Hispanic group versus non-Hispanic group. The odds of being treated in the Hispanic group were significantly lower in multiple Census regions with respect to surgical resection (New England, OR 0.51; Mountain, OR 0.68), chemotherapy (East North Central, OR 0.77; Middle Atlantic, OR 0.71; Pacific, OR 0.77), radiation therapy (Middle Atlantic, OR 0.77) and triple therapy (New England, OR 0.49; Middle Atlantic, OR 0.87; Pacific, OR 0.84). Significant barriers to triple therapy in the Hispanic group within these regions were older age (OR 0.97; P < 0.01), treatment in a community facility (OR 0.85, P = 0.03), lack of insurance (OR 0.71, P = 0.03), yearly income < $40,227 (OR 0.69, P < 0.01), low education levels (OR 0.75, P = 0.03) and presence of co-morbidity (OR 0.82; P < 0.01). CONCLUSIONS: Currently in the US, there exists heterogenous geographic disparities for Hispanic GBMpatients to access different treatments compared to non-Hispanic patients. Multiple circumstances can influence access to treatment within the Hispanic community of these regions, and greater investigation with more granularity required to reveal mechanisms in which these disparities may be addressed in the future.
Entities:
Keywords:
Access; Chemotherapy; Glioblastoma; Hispanic; Radiation; Surgery; United States
Authors: Krissia M Rivera Perla; Oliver Y Tang; Shayla N M Durfey; Tito Vivas-Buitrago; Wendy J Sherman; Ian Parney; Joon H Uhm; Alyx B Porter; Heinrich Elinzano; Steven A Toms; Alfredo Quiñones-Hinojosa Journal: J Neurooncol Date: 2022-05-03 Impact factor: 4.130
Authors: Victor M Lu; Daniel G Eichberg; Evan M Luther; Ashish H Shah; David J Daniels; Ossama M Maher; Toba N Niazi Journal: Childs Nerv Syst Date: 2021-10-13 Impact factor: 1.475
Authors: Victor M Lu; Evan M Luther; Daniel G Eichberg; Alexis A Morell; Ashish H Shah; Ricardo J Komotar; Michael E Ivan Journal: J Neurooncol Date: 2021-10-04 Impact factor: 4.130
Authors: Laura A Evans; Ronald Go; Rahma Warsame; Bharat Nandakumar; Francis K Buadi; Angela Dispenzieri; David Dingli; Martha Q Lacy; Suzanne R Hayman; Prashant Kapoor; Nelson Leung; Amie Fonder; Miriam Hobbs; Yi Lisa Hwa; Eli Muchtar; Taxiarchis V Kourelis; Stephen Russell; John A Lust; Yi Lin; Mustaqeem Siddiqui; Robert A Kyle; Morie A Gertz; S Vincent Rajkumar; Shaji Kumar; Wilson I Gonsalves Journal: Clin Lymphoma Myeloma Leuk Date: 2021-02-17
Authors: Jad Zreik; Panagiotis Kerezoudis; Mohammed Ali Alvi; Yagiz U Yolcu; Sani H Kizilbash Journal: Front Oncol Date: 2021-11-09 Impact factor: 6.244