DISP-02. PATTERNS IN THE INCIDENCE OF BRAIN METASTASIS BY RACE AND ETHNICITY: A SYSTEMATIC REVIEW

Abstract

Abstract INTRODUCTION Despite advancements in cancer treatment, the incidence of brain metastases (BM) continues to rise which necessitates risk factor analyses. Although current literature indicates racial variance in BM incidence, there exists a major knowledge gap in understanding associations between race/ethnicity, BM incidence, and subtypes which emphasizes the need for a systematic review. We aimed to analyze the relationship between BM incidence, race/ethnicity, and primary cancer type. METHODS Using PRISMA guidelines, a systematic review of PubMed and Ovid databases from January 2000 to January 2023 for terms related to BM, ethnicity and race, in conjunction with incidence was conducted. Inclusion criteria comprised peer-reviewed journals with ages > 18, sample size > 100, primary malignancy diagnosis with evidence of BM, and descriptions of patient race or ethnicity. RESULTS Of 806 identified studies, 11 articles primarily utilizing US data were included for final analysis. Lung and bronchus cancers, revealed the highest incidence of BM in Asian patients, followed by Black, White, and American Indian/Alaska Natives (P< .001), despite overall increased incidence of primary cancer in Black patients. Breast cancer revealed highest BM incidence in American Indian/Alaska Natives (5.9%), followed by Black (5.0%), White (3.6%), and Asian/Pacific Islanders (3.5%) (P< .001). When compared to White and Hispanics only, Black patients had greater incidences of BM (OR: 2.26, 95% CI: 1.57–3.25). Lower incidence of BM for esophageal cancer was observed in Black patients compared to White patients (OR=0.38; 95% CI: (0.16–0.89); P= 0.026). No significant differences were observed in BM incidence for bladder, prostate, or non-small cell and small cell lung cancers. CONCLUSIONS Our review suggests that BM incidence does vary amongst racial/ethnic groups dependent on primary cancer type. Differences may be due to numerous factors, underscoring the need for more work with inclusive, diverse cohorts to tackle BM disparities.