P09.02.B THE RELATIONSHIP BETWEEN SYMPTOMS AND THE SOCIAL DETERMINANTS OF HEALTH AMONG THE PRIMARY BRAIN TUMOR POPULATION: A SYSTEMATIC REVIEW

Abstract

Abstract BACKGROUND Social determinants of health (SDoH) account for up to half of all health outcomes in the general population, but their impact on symptoms is less understood, especially in rare cancers such as primary brain tumors (PBT). MATERIAL AND METHODS We reviewed the literature and examined the relationship between SDoH and mood and neurocognitive symptoms in the PBT population. PubMed, EMBASE, and CINAHL identified 3,006 publications. SDoH were defined using PROGRESS criteria (Place of residence, Race/ethnicity, Occupation, Gender, Religion, Education, Socioeconomic status, Social capital). Two individuals screened and assessed study bias. RESULTS Of 3,006 abstracts identified, 150 full text articles were assessed for eligibility and 48 studies were included with a total sample of 28,454 PBT participants. 27 studies were cross-sectional with the majority from single institutions in the US (12), Germany (10), or Netherlands (5). Sample sizes varied from 27 to 15,320. 22 studies examined the relationship with 1 of the PROGRESS categories and no study examined all 8. 4 studies measured place of residence, 2 race/ethnicity, 13 occupation, 43 gender, 1 religion, 18 education, 4 socioeconomic status, and 15 social capital. 37 studies reported on mood related symptoms with 20 focused on depression, 14 anxiety, and 11 distress. 15 studies assessed neurocognitive symptoms, while 4 assessed both mood and neurocognition. Among studies assessing neurocognition, 1 found a relationship with place of residence and socioeconomic status, 7 out of 10 reported a relationship with education, and 7 of 11 found no relationship with gender. None examined race/ethnicity or religion. Disparate results were found related to occupation. Among the 37 studies assessing mood, results were disparate except for place of residence, which related rural residence to depressive symptoms. Bias assessment revealed that 61% of the studies were fair in quality, 31% poor, and 8% good indicating the majority of studies had evidence of bias. CONCLUSION Most studies were descriptive or exploratory and lacked comprehensive inclusion of SDoH, which limited the opportunity to perform meta-analysis. This is the first systematic review examining the relationship of symptoms in the PBT population and SDoH to date. Future studies should use standardized collection of SDoH, reduce study bias, and encourage inclusion of diverse samples to identify gaps for the development of future interventions.