The Intersection of Race, Ethnicity, and Urbanicity on Treatment Paradigms and Clinical Outcomes for Non-Malignant Primary Tumors of the Spine
Document Type
Article
Publication Title
Cancer Epidemiology
Abstract
Background: Non-malignant primary tumors of the spine (NMPTS) patients in rural areas face unique barriers that may limit their capacity to receive optimal care. With a lower geographical distribution of neurosurgical specialists and limited healthcare infrastructure, rural NMPTS patients may receive certain treatments at a lower frequency than metropolitan patients. NMPTS We sought to examine the association between residential urbanicity, race-ethnicity, treatment patterns, and survival outcomes for cases diagnosed with NMPTS.
Methods: Cases of NMPTS diagnosed between 2004 and 2019 were identified from the Central Brain Tumor Registry of the United States (CBTRUS), a combined dataset of CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology and End Results (SEER) data. Using multivariable logistic regression, we evaluated the association between urbanicity and treatment (including surgery and radiation), adjusted for age at diagnosis, sex, and race-ethnicity. Patient-level all-cause survival data were obtained from the NPCR Survival Analytical Database (2004-2018).
Results: A total of 38,414 cases were identified, 33,097 of whom lived in metropolitan and 5317 of whom lived in non-metropolitan regions. Nerve sheath tumors and meningiomas were the most common tumor histopathologies across both regions, with no clinically significant difference in other histopathologies (p
Conclusion: Our data demonstrates significant differences in the incidence of NMPTS across both race-ethnicity and urbanicity. However, a wider analysis of all-cause mortality reveals disparities in health outcomes across both race-ethnicity and urbanicity for Black and Hispanic populations. To address the disparity in health outcomes, policymakers and health providers need to work with local communities in rural areas to improve access to equitable and quality healthcare.
DOI
10.1016/j.canep.2024.102657
Publication Date
9-5-2024
Keywords
non-malignant, outcomes, race, social CBTRUS, sociodemographic factors, spine surgery, spine tumor, urbanicity
ISSN
1877-783X
Recommended Citation
Bishop B, Hockenberry H, Sperber J, Owolo E, Baeta C, Price M, Neff C, Kruchko C, Barnholtz-Sloan JS, Charles AJ, Sciubba C, Ostrom QT, Johnson E, Goodwin C. The Intersection of Race, Ethnicity, and Urbanicity on Treatment Paradigms and Clinical Outcomes for Non-Malignant Primary Tumors of the Spine. Cancer Epidemiology. 2024; . doi: 10.1016/j.canep.2024.102657.
