KEY TAKEAWAYS
- The trial aimed to explore the impact of area deprivation on symptom duration, treatment access, and survival in patients with PBTs.
- The results showed that patients with PBT from socioeconomically disadvantaged areas face delays in accessing quality care, warranting future consideration.
Individuals living in areas of high deprivation, indicating socioeconomic disadvantage, often face challenges accessing treatment and experience higher mortality rates from cancer. However, little is known about how this deprivation affects the duration of symptoms, treatment accessibility, and survival among patients with primary brain tumors (PBTs).
Macy Stockdill and the team aimed to examine how area deprivation relates to the duration of symptoms before diagnosis, time to initial treatment, and overall survival among a cohort of 666 adults with PBTs participating in a substantial National Institutes of Health (NIH) observational trial.
The study utilized ordinal logistic regression to analyze the association between symptom duration (categorized as <6 months, 6 months-1 year, or ≥1 year) and area deprivation index (ADI) status (categorized as less advantaged or more advantaged), presenting ORs with 95% CIs.
Additionally, they employed linear regression to evaluate the relationship between time to treatment duration and ADI, providing beta coefficients along with 95% CIs. Adjustment for age at cancer diagnosis and gender (male or female) was made, with further stratification based on the residential distance to the National Institutes of Health (NIH) facilities (categorized as short distance, <200 miles, or long distance, 200+ miles).
Researchers subsequently employed Kaplan-Meier estimates to assess overall survival across different ADI levels based on residential distance. Furthermore, all models were stratified by tumor grade (low or high).
Among the 666 patients diagnosed with PBTs, 159 (24%) resided in less advantaged areas, while 40% lived long distances from treatment centers, and 24% had low-grade tumors. Individuals from less advantaged areas exhibited a higher 5-year survival rate compared to those from more advantaged areas (72.01% vs. 62.02%, P=0.02), although this difference was not significant when stratified by tumor grade (P=0.29 for low-grade tumors; P=0.09 for high-grade tumors).
The overall sample found no associations between ADI and symptom duration before diagnosis. However, time to any treatment was notably longer for all patients residing in less advantaged areas (β=7.78; 95% CI=0.02, 15.55), particularly among those with low-grade PBTs (β=36.19; 95% CI=12.17, 60.20).
Among individuals with low-grade PBTs living long distances from the NIH, the less advantaged group experienced a shorter duration of symptoms before diagnosis (OR=0.30; 95% CI=0.12, 0.75).
The study concluded that future consideration should be directed towards individuals diagnosed with PBTs who reside in socioeconomically disadvantaged areas, have low-grade PBTs, and live long distances from treatment centers. This demographic may encounter prolonged delays in accessing quality medical care on average.
The trial was sponsored by the National Cancer Institute (NCI).
Source: https://ons.confex.com/ons/2024/meetingapp.cgi/Paper/14915
Clinical Trial: https://clinicaltrials.gov/study/NCT02851706
Stockdill M, Vo JB, Kim Y, et al. (2024). “Impact of socioeconomic disadvantage on symptom duration, treatment initiation, and survival among primary brain tumor patients: A large cohort analysis.” Presented at ONS 2024 (RS76)
