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Updated: May 23, 2026
Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections
Published on: July 31, 2017
Disparities in access to optimal glioma care: a systematic review and meta-analysis
1Department of Paediatric Neurosurgery, Children's Hospital Named After Prof. Dr Med. Jan Bogdanowicz, Warsaw, Poland.
Background:
Disparities in neuro-oncologic care are increasingly recognized, but their cumulative impact across the glioma treatment continuum remains unclear. Prior studies have largely examined isolated aspects of care without integrating access, treatment delivery, and survival outcomes.
Methods:
A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 and guidelines. Observational studies published between 2010 and 2025 examining socioeconomic, insurance-related, geographic, or health-system disparities in adult glioma were identified. Odds ratios (ORs) and hazard ratios (HRs) were pooled using random-effects models.
Results:
Ten studies encompassing more than 180,000 patients were included. Disadvantaged patients experienced significantly worse overall survival, corresponding to a 39% higher mortality risk (HR 1.39, 95% CI 1.17-1.66). They also had higher odds of delayed or suboptimal adjuvant therapy (OR 1.41, 95% CI 1.12-1.78). Differences in access to optimal care were directionally consistent but heterogeneous (OR 1.10, 95% CI 0.79-1.52). Effect estimates were concordant across studies and stable in leave-one-out analyses. No statistically significant small-study effects were detected (Egger's test p = 0.051).
Conclusions:
Structural disadvantage is associated with reduced access to care, lower treatment intensity, and worse survival in adult glioma, underscoring the need for system-level interventions to address socioeconomic and geographic inequities.
Protocol Registration:
www.crd.york.ac.uk/prospero identifier is CRD420261277787.
