Date of Award
Master of Public Health (MPH)
School of Public Health
PURPOSE: It is unclear what role sociodemographic predictors have on the subtype-specific survival patterns of patients with low-grade gliomas. Understanding these effects may help guide and improve public health intervention strategies for patients with this relatively rare, understudied condition. METHODS: Using the Surveillance, Epidemiology, and End Results Program, we identified adult cases (aged 20-79 years) diagnosed with a World Health Organization Central Nervous System grade II supratentorial astrocytoma, oligodendroglioma, or mixed glioma between 1975-2019. Kaplan-Meier estimates and multivariable Cox models were utilized to assess factors associated with survival. RESULTS: The final cohort included 4,684 adult grade II glioma cases with a median survival of 5.7 (95% confidence interval [CI]: 5.3-6.1) years. Approximately 10% of patients diagnosed in 1975-1994 survived at least 25 years. The median survival for oligodendroglioma, mixed glioma, and astrocytoma patients was 13.7 (95% CI: 12.7-14.9), 9.3 (95% CI: 7.9-10.5), and 2.5 (95% CI: 2.3-2.8) years, respectively (log-rank p <0.01). In the multivariable model, oligodendroglioma cases had better survival than astrocytoma cases (hazard ratio [HR]=0.40, 95% CI: 0.34-0.46, p<0.01). Men had a 17% (95% CI: 1.04,1.31, p=0.01) increased risk of death relative to women. Astrocytoma patients residing in metropolitan areas had a lower risk of death than non-metropolitan residents (HR=0.77, 95% CI: 0.60-0.98, p=0.03). Among patients with mixed glioma, divorced or separated patients had inferior survival than their married counterparts (HR=2.97, 95% CI: 1.28-6.91, p<0.01). CONCLUSIONS: Altogether, our findings indicate that the effects of demographic factors on low-grade glioma survival vary by subtype, and that further work is required to explain these associations.
Krick, Mathew, "Demographic Factors In Adult Low-Grade Glioma Survival: A Seer Study" (2023). Public Health Theses. 2283.
This thesis is restricted to Yale network users only. It will be made publicly available on 05/10/2024