title: The survival of patients with high grade glioma from different ethnic groups in South East England.
abstract: Studies in the United States (US) have reported varying treatment and survival for patients with high grade glioma from different ethnic groups. This study investigates for the first time whether differences also exist in the United Kingdom (UK). This population-based cohort study used cancer registration data for 4,845 patients diagnosed in South East England between 2000 and 2009. Linked self-assigned ethnicity data within Hospital Episode Statistics were used to define White, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, Other and Not known groups. Logistic regression was used to generate odds ratios for a record of receipt of treatment (surgery, radiotherapy and chemotherapy), adjusting for sex, age, morphology, socioeconomic deprivation and comorbidity in each ethnic group. Hazard ratios were generated using Cox regression, adjusting for sex, age, morphology, socioeconomic deprivation, comorbidity and treatment. The overall one-year survival was 28.4 %. Ethnicity data was available for 3,793 (78 %) patients. Receipt of treatment was generally similar between different ethnic groups after adjustment for sex, age, morphology, socioeconomic deprivation and comorbidity. After adjustment for potential confounders, the Indian (HR 0.72, p = 0.037) and Other groups (HR 0.76, p = 0.003) had better survival, while the Not known group (HR 1.34, p < 0.0001) had worse survival than the White group. Patients from UK Indian groups have better survival than White patients while those from Black ethnic groups appear to have similar survival to White patients. These findings suggest the need to investigate possible contributing factors including the completeness of follow-up, clinical performance status and tumour biology.
authors.affiliation: Cancer Epidemiology and Population Health, Research Oncology, King's College London, 3rd Floor, Bermondsey Wing, Guy's Campus, London, SE1 9RT, UK, tratneswaren@nhs.net.
authors.forename: T
authors.initials: T
authors.lastname: Ratneswaren
authors.forename: R M
authors.initials: RM
authors.lastname: Jack
authors.forename: D
authors.initials: D
authors.lastname: Tataru
authors.forename: E A
authors.initials: EA
authors.lastname: Davies
mesh_terms: D001932:Brain Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D004739:England / Q000453:epidemiology; D005910:Glioma / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D060787:Neoplasm Grading; D016016:Proportional Hazards Models; D012042:Registries; D016019:Survival Analysis