Introduction: Studies have demonstrated racial disparities in clinical outcomes across medical and surgical populations. Urbanicity, living in a densely populated area, can contribute to care these disparities. This study aims to compare clinical outcomes and survival in racial and ethnic minority groups from metropolitan areas to racial and ethnic minority groups from non-metropolitan areas.
Methods: Histopathologically confirmed cases of PNTs of the spine diagnosed between 2004 and 2019 were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) with incidence rates calculated per 100,000 people and standardized to the 2000 U.S. population. Multivariable logistic regression models were to evaluate the association between urbanicity and incidence, and adjusted for age at diagnosis, sex, race, and ethnicity.
Results: Our study includes 34,281 Metropolitan and 5,480 Non-Metropolitan patients. Overall survival of PNTs in a non-metropolitan area was lower compared to metropolitan areas (p < 0.001; HR: 1.17; CI: 1.09-1.25). Survival for non-Hispanic (NH) Asian and Pacific Islander (API) patients increased (p < 0.001; HR: 0.61; CI: 0.51-0.73), with increased survivability in metropolitan patients compared to non-metropolitan (p=0.03). However, the survival of NH Black patients in decreased (p < 0.001; HR: 1.47; CI: 1.34-1.62), with a higher survival probability in non-metropolitan areas (p=0.027).
Conclusion : Among patients diagnosed with a PNT, Non-Hispanic API and Non-Hispanic Blacks had greater survival, in comparison to their non-metropolitan counterparts. Given the differences in survivability among NH Black Patients and NH API, there may be additional confounding variables related to barriers to care. The cause may be multifactorial and further investigation into the intersection of race/ethnicity and urbanicity may be needed.
