Glioma incidence and survival variations by county-level socioeconomic measures

2019 · Unclear · Moderate evidence

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UnclearModerate evidencePaper 1786

Study snapshot

Publicationmanual · 2019

Study typecohort

Reported directionUnclear

Evidence ratingModerate

Abstract

Glioma incidence and survival variations by county-level socioeconomic measures Cote DJ, Ostrom QT, Gittleman H, Duncan KR, CreveCoeur T, Kruchko C, Smith TR, Stampfer MJ, Barnholtz-Sloan J. Glioma incidence and survival variations by county-level socioeconomic measures. Cancer. 2019 Jun 17. doi: 10.1002/cncr.32328. Abstract BACKGROUND: Multiple studies have reported higher rates of glioma in areas with higher socioeconomic status (SES) but to the authors' knowledge have not stratified by other factors, including race/ethnicity or urban versus rural location. METHODS: The authors identified the average annual age-adjusted incidence rates and calculated hazard ratios for death for gliomas of various subtypes, stratified by a county-level index for SES, race/ethnicity, US region, and rural versus urban status. RESULTS: Rates of glioma were highest in counties with higher SES (rate ratio, 1.18; 95% CI, 1.15-1.22 comparing the highest with the lowest quintiles [P < .001]). Stratified by race/ethnicity, higher rates in high SES counties persisted for white non-Hispanic individuals. Stratified by rural versus urban status, differences in incidence by SES were more pronounced among urban counties. Survival was higher for residents of high SES counties after adjustment for age and extent of surgical resection (hazard ratio, 0.82; 95% CI, 0.76-0.87 comparing the highest with the lowest quintile of SES [P < .001]). Survival was higher among white Hispanic, black, and Asian/Pacific Islander individuals compared with white non-Hispanic individuals, after adjustment for age, SES, and extent of surgical resection, and when restricted to those individuals with glioblastoma who received radiation and chemotherapy. CONCLUSIONS: The incidence of glioma was higher in US counties of high compared with low SES. These differences were most pronounced among white non-Hispanic individuals and white Hispanic individuals residing in urban areas. Better survival was observed in high SES counties, even when adjusting for extent of surgical resection, and when restricted to those who received radiation and chemotherapy for glioblastoma. Differences in incidence and survival were associated with SES and race, rather than rural versus urban status. Conflict of Interest Disclosures Quinn T. Ostrom was supported by a Research Training Grant from the Cancer Prevention and Research Institute of Texas (RP160097T). Meir J. Stampfer has served as a paid expert witness for Verizon (represented by the Alston Bird Law firm) in a lawsuit regarding the alleged link between cell phones and brain cancer for work performed outside of the current study. The law firm and company had no knowledge of or influence on the current study. The other authors made no disclosures. ncbi.nlm.nih.gov

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecohort

Effect directionunclear

PopulationUS county residents with glioma (various subtypes), stratified by county-level socioeconomic status, race/ethnicity, US region, and rural vs urban status

Sample sizeNot supplied

ExposureNot supplied

Evidence strengthModerateConfidence: 74% · Peer reviewed: yes

Main findings

Glioma incidence rates were higher in counties with higher socioeconomic status (rate ratio 1.18, 95% CI 1.15-1.22 comparing highest vs lowest SES quintile; P<.001), with the higher incidence in high-SES counties persisting for white non-Hispanic individuals and being more pronounced in urban counties. Survival was higher for residents of high-SES counties after adjustment for age and extent of surgical resection (HR 0.82, 95% CI 0.76-0.87 comparing highest vs lowest SES quintile; P<.001).

Outcomes measured

Age-adjusted glioma incidence rate (rate ratios by SES quintile)
Survival (hazard ratios for death)

View raw extracted JSON

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  "study_type": "cohort",
  "exposure": {
    "band": null,
    "source": null,
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "US county residents with glioma (various subtypes), stratified by county-level socioeconomic status, race/ethnicity, US region, and rural vs urban status",
  "sample_size": null,
  "outcomes": [
    "Age-adjusted glioma incidence rate (rate ratios by SES quintile)",
    "Survival (hazard ratios for death)"
  ],
  "main_findings": "Glioma incidence rates were higher in counties with higher socioeconomic status (rate ratio 1.18, 95% CI 1.15-1.22 comparing highest vs lowest SES quintile; P<.001), with the higher incidence in high-SES counties persisting for white non-Hispanic individuals and being more pronounced in urban counties. Survival was higher for residents of high-SES counties after adjustment for age and extent of surgical resection (HR 0.82, 95% CI 0.76-0.87 comparing highest vs lowest SES quintile; P<.001).",
  "effect_direction": "unclear",
  "limitations": [],
  "evidence_strength": "moderate",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "glioma",
    "glioblastoma",
    "incidence",
    "survival",
    "socioeconomic status",
    "SES",
    "county-level",
    "race/ethnicity",
    "urban",
    "rural",
    "United States"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1002/cncr.32328
PubMed: Not supplied

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