Differences in primary molecular subtype distribution contribute to racial and ethnic disparities in adult-type diffuse gliomas

Resumo

Abstract Background Molecular profiling has become an integral part of glioma classification. The extent to which the incidence of molecularly defined adult-type gliomas varies by demographics is unknown. We describe national-level incidence and overall survival patterns of selected glioma subtypes by race/ethnicity. Methods We generated standardized average annual age-adjusted incidence rates of molecularly defined glioma subtypes by race/ethnicity from the Central Brain Tumor Registry of the United States (CBTRUS) using newly diagnosed cases from January 1, 2018, to December 31, 2022. Survival data from the National Cancer Database (NCDB) were used from newly diagnosed cases from January 1, 2018, to December 31, 2021 (with follow-up through December 31, 2022) to evaluate 4-year overall survival, median survival, and multivariable Cox proportional hazards ratios. Results CBTRUS identified 68 172 glioma cases; IDH-wild-type glioblastoma was most common (n = 51 548). Non-Hispanic White individuals had a significantly higher incidence of all gliomas compared to other groups (P > .001). Non-Hispanic Black individuals had the lowest incidence for IDH-mutant astrocytoma and oligodendroglioma, and shared lowest incidence of IDH-mutant glioblastoma and IDH-wild-type astrocytoma with non-Hispanic other individuals, who had the lowest incidence of IDH-wild-type glioblastoma (P < .001). The odds of having an IDH-mutant (versus IDH-wildtype) astrocytoma or glioblastoma were significantly lower for males, those of older age, and non-Hispanic Black individuals (P < .001). Non-Hispanic other individuals also had increased adjusted overall survival for most glioma subtypes compared to other racial/ethnic groups (P < .001). Four-year overall survival was lowest in all racial/ethnic groups for IDH-wild-type glioblastoma (P < .001). Conclusions Our findings reveal significant disparities in incidence and survival by race/ethnicity with notable variations present based on glioma biomarkers.