DISP-06. THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON TREATMENT DELAYS FOR GLIOBLASTOMA

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2024-11, Vol.26 (Supplement_8), p.viii147-viii148
• Main Authors: Cioffi, Gino, Gratzl, Samuel, Dmukauskas, Mantas, Waite, Kristin, Sloan, Andrew, Mammoser, Aaron, Stucky, Nicholas, Barnholtz-Sloan, Jill
• Format: Article
• Language: English
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/noae165.0580

Abstract Social determinants of health (SDOH) contribute to treatment delays for a variety of diseases. However, the impact of SDOH on delays in treatment for glioblastoma (GBM) is not well established. Utilizing the Truveta database, which includes electronic health records, claims, linked SDOH data, and medication dispense data for a collective of US health systems, we evaluated individuals diagnosed with GBM from 1/1/2018-5/16/2024 who received either surgery, radiation, or temozolomide. Univariable and multivariable logistic regression modeling was performed to assess the odds of experiencing a delay in surgery (>7 days after diagnosis), radiation (>30 days after diagnosis), or temozolomide (>30 days after diagnosis). Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) are reported. Models were assessed for demographic (sex, age, race) and SDOH factors (education, income, social support, transportation, housing stability). At the univariable level, college attendance and single-member household were associated with delays in surgery but were not significant in the multivariable model. Individuals diagnosed with GBM at ages of 45-64 and 65+ were less likely to experience delays in surgery than individuals ages 18-44 (45-64 aOR (95%CI): 0.58(0.38-0.89), 65+ aOR (95%CI): 0.42(0.25-0.71)). Additionally, individuals with an estimated yearly income of $60,001-$120,000 were 61% more likely to experience delays in surgery compared to individuals with an estimated income of $120,000 were associated with delays in radiation. However, no significant factors were associated with delays in radiation after adjustment. Individuals ages 45-64 and 65+ were less likely to encounter delays in temozolomide than individuals ages 18-44 (45-64 aOR (95%CI): 0.64(0.46-0.88), 65+ aOR (95%CI): 0.62(0.43-0.91)). Understanding how SDOH impact treatment patterns provides vital insight on diverse factors that impact patient care.