Associations between urbanicity and spinal cord astrocytoma management and outcomes.

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Sykes, David AW

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Waguia, Romaric

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Abu-Bonsrah, Nancy

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Price, Mackenzie

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Dalton, Tara

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Sperber, Jacob

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Owolo, Edwin

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Hockenberry, Harrison

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Bishop, Brandon

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Kruchko, Carol

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Barnholtz-Sloan, Jill S

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Erickson, Melissa

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Ostrom, Quinn T

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Goodwin, C Rory

dc.date.accessioned

2024-08-14T15:37:49Z

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2024-08-14T15:37:49Z

dc.date.issued

2023-10

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Background

The management of spinal cord astrocytomas (SCAs) remains controversial and may include any combination of surgery, radiation, and chemotherapy. Factors such as urbanicity (metropolitan versus non-metropolitan residence) are shown to be associated with patterns of treatment and clinical outcomes in a variety of cancers, but the role urbanicity plays in SCA treatment remains unknown.

Methods

The Central Brain Tumor Registry of the United States (CBTRUS) analytic dataset, which combines data from CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology, and End Results Programs, was used to identify individuals with SCAs between 2004 and 2019. Individuals' county of residence was classified as metropolitan or non-metropolitan. Multivariable logistic regression models were used to evaluate associations between urbanicity and SCA. Cox proportional hazard models were constructed to assess the effect of urbanicity on survival using the NPCR survival dataset (2004-2018).

Results

1697 metropolitan and 268 non-metropolitan SCA cases were identified. The cohorts did not differ in age or gender composition. The populations had different racial/ethnic compositions, with a higher White non-Hispanic population in the non-metropolitan cohort (86 % vs 66 %, p < 0.001) and a greater Black non-Hispanic population in the metropolitan cohort (14 % vs 9.9 %, p < 0.001). There were no significant differences in likelihood of receiving comprehensive treatment (OR=0.99, 95 % CI [0.56, 1.65], p = >0.9), or survival (hazard ratio [HR]=0.92, p = 0.4) when non-metropolitan and metropolitan cases were compared. In the metropolitan cohort, there were statistically significant differences in SCA treatment patterns when stratified by race/ethnicity (p = 0.002).

Conclusions

Urbanicity does not significantly impact SCA management or survival. Race/ethnicity may be associated with likelihood of receiving certain SCA treatments in metropolitan communities.
dc.identifier

S1877-7821(23)00111-X

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1877-7821

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1877-783X

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https://hdl.handle.net/10161/31369

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eng

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Elsevier BV

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Cancer epidemiology

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10.1016/j.canep.2023.102431

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Central brain tumor registry

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Race/ethnicity

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Radiation

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Social determinants of health

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Spinal cord astrocytoma

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Surgery

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Survival

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Urbanicity

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Associations between urbanicity and spinal cord astrocytoma management and outcomes.

dc.type

Journal article

duke.contributor.orcid

Ostrom, Quinn T|0000-0003-3469-7558

duke.contributor.orcid

Goodwin, C Rory|0000-0002-6540-2751

pubs.begin-page

102431

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Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Orthopaedic Surgery

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Radiation Oncology

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Duke Cancer Institute

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Neurosurgery

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Population Health Sciences

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Neurosurgery, Neuro-Oncology

pubs.publication-status

Published

pubs.volume

86

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