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Racial/ethnic disparities in treatment pattern and time to treatment for adults with glioblastoma in the US

  • Clinical Study
  • Published:
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Abstract

Purpose

Race/ethnicity have been previously shown to significantly affect survival after diagnosis with glioblastoma, but the cause of this survival difference is not known. The aim of this study was to examine variation in treatment pattern and time to treatment by race/ethnicity, and the extent to which this affects survival.

Methods

Data were obtained from the National Cancer Database (NCDB) for adults ≥ 40 with glioblastoma from 2004 to 2016 (N = 68,979). Treatment patterns and time to treatment by race/ethnicity were compared using univariable and multivariable logistic and linear regression models, respectively, and adjusted for known prognostic factors and factors potentially affecting health care access.

Results

Black non-Hispanics (BNH) and Hispanics were less likely to receive radiation and less likely to receive chemotherapy as compared to White non-Hispanics (WNH). Time to radiation initiation was ~ 2 days longer and time to chemotherapy initiation was ~ 4 days longer in both groups in comparison to WNH.

Conclusion

Both race/ethnicity and treatment timing significantly affected survival time, and this association remained after adjustment for known prognostic factors. Additional research is necessary to disentangle the specific causal factors, and the mechanism with which they affect survival.

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Data availability

The National Cancer Database (NCDB) data that support the findings of this study are available from American College of Surgeons and the American Cancer Society. Restrictions apply to the availability of these data, which were used under license for this study. Data are available at https://www.facs.org/quality-programs/cancer/ncdb for investigators at Commission on Cancer (CoC) accredited facilities with an approved data request.

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Funding

QTO is supported by a Research Training Grant from the Cancer Prevention and Research Institute of Texas (CPRIT; RP160097T).

Author information

Authors and Affiliations

  1. Department of Medicine, Section of Epidemiology and Population Sciences, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA

    Quinn T. Ostrom

  2. The Ohio State University, Columbus, OH, USA

    Halle L. Krebs

  3. Research Health Analytics and Informatics, University Hospitals Health System (UHHS), Cleveland, OH, USA

    Nirav Patil & Jill S. Barnholtz-Sloan

  4. Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, 2-526 Wolstein Research Building, 2103 Cornell Road, Cleveland, OH, 44106-7295, USA

    Gino Cioffi & Jill S. Barnholtz-Sloan

  5. Cleveland Center for Health Outcomes Research (CCHOR), Cleveland, OH, USA

    Gino Cioffi & Jill S. Barnholtz-Sloan

  6. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Jill S. Barnholtz-Sloan

  7. Cleveland Institute for Computational Biology, Cleveland, OH, USA

    Jill S. Barnholtz-Sloan

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  1. Quinn T. Ostrom
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Contributions

QTO and JSB designed the project. QTO, GC and NP planned analytic approach. QTO performed all analyses. QTO and HK wrote the manuscript. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Jill S. Barnholtz-Sloan.

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Ostrom, Q.T., Krebs, H.L., Patil, N. et al. Racial/ethnic disparities in treatment pattern and time to treatment for adults with glioblastoma in the US. J Neurooncol 152, 603–615 (2021). https://doi.org/10.1007/s11060-021-03736-4

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  • DOI: https://doi.org/10.1007/s11060-021-03736-4

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