Abstract
BackgroundGlioma rates vary by demographic factors and geo-political boundaries and this variation suggests higher glioma rates in groups of higher socioeconomic position. The primary goal of this analysis is to investigate the relationship between glioma and county socioeconomic position using U.S. Surveillance Epidemiology and End Results (SEER) data.MethodsCases were individuals 25+ years diagnosed with glioma between 2000 and 2006 and residing within the SEER-17 catchment area. County-, sex-, race-, age-specific rates were created in order to investigate individual-level associations (population data from U.S. Census 2000). A Bayesian hierarchical Poisson spatial conditionally autoregressive (CAR) model was utilized to simultaneously estimate individual- and county-level associations while controlling for county spatial dependence.ResultsThose residing in counties of the second, third, and fourth highest quartiles of socioeconomic position have glioma incidence rates that are 1.10 (95% CI: 1.02,1.19), 1.11 (95% CI: 1.02,1.20), 1.14 (95% CI: 1.05,1.23) times that of the first quartile, respectively. A CAR model properly controlled for error spatial dependence. Investigated lag times suggest year 2000 census data yields superior model fit.ConclusionDemographically adjusted rates of glioma are elevated in counties of higher socioeconomic position. More well-grounded theory concerning the glioma-socioeconomic position association along with socioeconomic data collected at multiple levels is recommended for future studies investigating this relationship.
Highlights
Glioma comprise approximately 80% of all primary malignant brain and central nervous system tumors in the U.S [1]
Data Description Data were gathered from the Surveillance Epidemiology and End Results (SEER) Program of the National Cancer Institute, which, for the time period of these analyses, collected information on all invasive tumors diagnosed among residents of 17 U.S regions [8]
Glioma rates ranged from a low of 1.12 in Socorro County, New Mexico to a high of 24.90 in Pocahontas County, Iowa, with 7.78 as the overall rate for the study region
Summary
Glioma comprise approximately 80% of all primary malignant brain and central nervous system tumors in the U.S [1]. The 2005–2009, average annual, age-adjusted incidence rate of glioma was 7.2 (per 100,000 person-years) among males and 5.1 among females, and the rate varied considerably by race (at least two fold increase comparing whites to blacks across several glioma subtypes) [1]. A study of glioblastoma multiforme, the dominant and largely fatal glioma subtype, revealed similar sex and race differences while demonstrating higher rates among those residing in high socioeconomic areas (rate ratio (RR) = 1.3, 95% confidence interval (CI) 1.2,1.4), even after statistical adjustment for confounding factors [3]. A recent Swedish study reported an increased odds of glioma among those with a higher family income (odds ratio (OR) 1.5, 95% CI: 1.1, 2.1), adjusted for sex, age, and geographic region [4]. Glioma rates vary by demographic factors and geo-political boundaries and this variation suggests higher glioma rates in groups of higher socioeconomic position. The primary goal of this analysis is to investigate the relationship between glioma and county socioeconomic position using U.S Surveillance Epidemiology and End Results (SEER) data
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