Work

An analysis of the influence of social determinants of health on treatment and survival among adult patients with high-grade glioma in Utah

Year: 2025

Type: article

Abstract: Background Social determinants of health (SDOHs) may impact outcomes of patients with high-grade glioma (HGG). We examined the effect of rurality and socioeconomic status on treatment and survival of patients with newly diagnosed HGG. Methods This retrospective analysis used 2 cohorts from the Utah Cancer Registry, including all patients diagnosed with HGG (2000-2019) (cohort 1) and all HGG patients who underwent surgery (2000-2020) (cohort 2). Patient demographics were evaluated descriptively. Kaplan-Meier curves, log-rank tests, and multivariable Cox regression analysis were used for survival analyses. Results Patients from cohort 1 living in Frontier (n = 60), Rural (n = 363), and Urban (n = 1502) Utah traveled mean distances of 95.9 ± 69.7, 50.0 ± 66.5, and 10.7 ± 11.3 miles, respectively, for treatment (P < .001). Urban patients were diagnosed at a younger age (54.2 ± 20.2 years) than patients from Frontier (56.8 ± 20.3 years) and Rural (57.3 ± 17.6 years) areas (P < .019). Frontier patients were more likely to have lower income than Urban patients (30.7% vs 65.5%, P < .001). Rural patients (13.0 months [95% CI 11.2-14.8]) experienced shorter median survival than Urban patients (16 months [95% CI 14.3-17.7]) (P = .049). Among patients undergoing surgery, those with private insurance (54.2%, P < .001) and in high-income (60.2%, P = .007) and socioeconomic (60.4%, P = .005) quartiles received adjuvant chemotherapy and radiation more frequently. Conclusion HGG patients from Frontier and Rural counties in Utah encountered greater SDOH barriers without experiencing delays in resection. Rural patients had shorter survival than Urban patients. Further investigation is needed to determine whether additional SDOHs (income and insurance status) may intersect and contribute to shorter survival and less access to adjuvant therapy.

Source: Neuro-Oncology Practice

DOI: 10.1093/nop/npaf029

Authors: Emma R Earl, Cody J Orton, Samuel A Tenhoeve, Clayton Rawson, Michael Karsy, Randy L Jensen

Institutions: University of Utah, Noorda College of Osteopathic Medicine, University of Michigan, Huntsman Cancer Institute

Language: English

Topic: Glioma Diagnosis and Treatment

Subfield: Genetics

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

Estimated APC paid: $5,036