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Racial differences in brain cancer characteristics and survival: an analysis of SEER data

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Abstract

Purpose

Racial disparity with shorter survival for Blacks than Whites is well known for many cancers. However, for brain cancer, some national cancer registry studies have shown better survival among Blacks compared to Whites. This study aimed to systematically investigate whether Blacks and Whites differ in survival and also in tumor characteristics and treatment for neuroepithelial brain tumors.

Methods

The National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) database was used to identify non-Hispanic White and Black patients diagnosed with malignant, histologically confirmed neuroepithelial brain cancer from 2004 through 2015. Racial differences in brain cancer survival were compared using Kaplan–Meier curve and Cox proportional hazard models. The associations of race with tumor and treatment characteristics (location, size, grade, surgical type) were examined using multinomial logistic regression.

Results

After adjusting for demographic, tumor, and treatment factors, there were no significant differences in survival for non-Hispanic Blacks compared to non-Hispanic Whites [hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.99–1.10]. Non-Hispanic Blacks had higher odds of being diagnosed with tumors of unknown grade [odds ratio (OR) 1.16, 95% CI 1.05–1.29], unknown size (OR 1.14, 95% CI 1.01–1.29), infratentorial (OR 1.12, 95% CI 1.01–1.24) or overlapping area (OR 1.39, 95% CI 1.14–1.70), and lower odds of having a total surgical resection (OR 0.83, 95% CI 0.74–0.93).

Conclusion

Non-Hispanic Blacks do not exhibit longer brain cancer-specific survival than non-Hispanic Whites. They were more likely to have tumors of unknown size or grade and less likely to receive total surgical resection, which may result from racial differences in access to and use of healthcare.

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Funding

This project was supported by the Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center under the auspices of the Henry M. Jackson Foundation for the Advancement of Military Medicine.

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Authors and Affiliations

  1. John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, USA

    Julie A. Bytnar, Jie Lin, Craig D. Shriver & Kangmin Zhu

  2. Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA

    Julie A. Bytnar, Jie Lin & Kangmin Zhu

  3. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Jie Lin & Craig D. Shriver

  4. Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Kangmin Zhu

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  1. Julie A. Bytnar
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Correspondence to Kangmin Zhu.

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Bytnar, J.A., Lin, J., Shriver, C.D. et al. Racial differences in brain cancer characteristics and survival: an analysis of SEER data. Cancer Causes Control 30, 1283–1291 (2019). https://doi.org/10.1007/s10552-019-01239-2

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  • DOI: https://doi.org/10.1007/s10552-019-01239-2

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