Distance traveled to glioblastoma treatment: A measure of the impact of socioeconomic status on survival

Clin Neurol Neurosurg. 2021 Oct:209:106909. doi: 10.1016/j.clineuro.2021.106909. Epub 2021 Aug 28.

Abstract

Background: Previous studies have shown improved post-surgical outcomes in patients who travel farther for glioblastoma treatment. This study investigates socioeconomic and facility factors that may influence this relationship.

Methods: Overall survival was calculated and compared by distance to treatment facility using univariate and multivariate survival models. The analysis was stratified by facility type, income quartile and insurance status and the association re-evaluated. Kaplan-Meier survival curves were created to analyze the relationship between overall survival and distance group.

Results: Individuals who traveled less than 5 miles to treatment had the shortest overall survival (11.8 months), while those who traveled greater than 50 miles had the longest survival (12.9 months). Stratification by income quartile failed to demonstrate an association between distance traveled and survival for those making less than $63,000 (adjusted hazard ratio range: 0.94-1.01). There was no association between survival and distance traveled for patients treated at a community cancer center, comprehensive community cancer center or an integrated network cancer program (adjusted hazard ratio range: 0.86-1.04).

Conclusion: Financial strain, rather than distance traveled to treatment, may be associated with glioblastoma survival.

Keywords: Distance traveled; Glioblastoma; Glioma; Health Disparities; Socioeconomic Status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Neoplasms / therapy*
  • Female
  • Glioblastoma / therapy*
  • Health Services Accessibility*
  • Humans
  • Income
  • Male
  • Middle Aged
  • Retrospective Studies
  • Social Class*
  • Socioeconomic Factors
  • Time Factors
  • Travel