Abstract
Abstract BACKGROUND Sociodemographic factors are well known to contribute to health disparities for different cancer diagnoses, but they are not extensively studied for glioma patients. In this study socioeconomic status (SES), travel time to health care, cohabitation status, and region (northern Sweden compared to three regions in southern Sweden) were investigated in relation to prognosis for patients with glioma WHO grade I-IV. MATERIAL AND METHODS The Swedish National Quality Registry for Brain Tumors was used to identify 1276 patients with glioma WHO grade I-IV, diagnosed 2009-2013. The Swedish population-based database RISK North combines data from several health care and demographic registries through the unique personal identity number. The RISK North was used to study survival in relation to SES, cohabitation status (living alone vs living with another adult person), travel time to the closest regional hospital (i.e. the closest hospital with a neurosurgical unit), and region. Educational level was used as a proxy for SES. RESULTS In univariable survival analysis, patients with glioma WHO grade III-IV and high SES had a longer survival compared to patients with low SES (middle school (ref) HR:1, high school HR:0.67 CI[0.56-0.81], university/college HR:0.65 CI[0.53-0.79], p<0.0001). In the multivariable model for the same group, survival was longer for patients with higher SES (middle school (ref) HR:1, high school HR:0.81 CI[0.67-0.98], p=0.033; university/college HR:0.81 CI[0.66-1.00], p=0.048). For patients with glioma WHO grade I-IV, there were no significant differences in survival in relation to travel time, cohabitation status, or region in multivariable survival analysis. CONCLUSION Survival was significantly worse in patients with lower SES compared to higher SES for patients with glioma WHO grade III-IV. No significant differences were found in survival in relation to cohabitation status (between those living alone and those living with another adult person), travel time to regional hospital, or between the northern Sweden and three regions in southern Sweden.
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