Socioeconomic status as a determinant of survival in glioblastoma: a systematic review and meta-analysis.

Abstract

Studies highlight the importance of social factors, such as race and socioeconomic status (SES), in disease management. Integrating these factors helps improve understanding of disease outcomes and the development of effective treatments. Thus, we aimed to systematically identify and review relevant studies exploring the relationship between SES and survival outcomes in GBM patients. An extensive exploration of academic databases, including Scopus, EMBASE, and PubMed, was undertaken, covering records from their inception until December 14, 2024. This search targeted specific keywords and their synonymous terms: glioblastoma, survival, and socioeconomic. We included 230,601 patients, with many individuals being diagnosed between the ages of 46 and 65. Notably, Female exhibited a higher risk (HR = 1.07, 95% CI: 1.05-1.09) of death compared to male, while African Americans demonstrated a higher risk than Caucasians (HR = 0.92, 95% CI: 0.88-0.97), alongside Hispanics (HR = 0.85, 95% CI: 0.72-0.99) and other races (HR = 0.78, 95% CI: 0.73-0.85). Similarly, unmarried individuals faced a higher risk (HR = 1.14, 95% CI: 1.09-1.20) compared to married counterparts. Noteworthy trends were observed in insurance, where private payers (HR = 1.11, 95% CI: 1.06-1.15) and government-based insurance (HR = 1.09, 95% CI: 1.00-1.19) showed increased risks compared to private insurance. However, associations in widowhood (HR = 2.45, 95% CI: 0.34-17.40), comorbidities (HR = 1.05, 95% CI: 0.93-1.18), median household income (MHI) (HR = 0.94, 95% CI: 0.85-1.05), and rural living (HR = 1.06, 95% CI: 0.98-1.16) were non-significant or inconclusive. These findings emphasize the complex interplay between socioeconomic factors and health risks, highlighting the necessity for tailored interventions to address health disparities across diverse demographic groups.