BACKGROUND Despite aspirations to achieve equality in healthcare we know that socioeconomic differences exist and may affect treatment and patient outcome, also in serious diseases such as cancer. We investigated disparities in neurosurgical care and outcome for patients with low-grade glioma (LGG). METHODS In this nationwide registry-based study, patients who had undergone surgery for LGG during 2005-2015 were identified (n = 547) through the Swedish Brain Tumor Registry. We linked data to multiple national registries with individual level data on income, education and comorbidity and analyzed the association of disease characteristics, surgical management and outcome, with levels of income, education and sex. RESULTS Patients with either low income, low education or female gender showed worse pre-operative performance status. Patients with low income or education also had more comorbidities and those with low education endured longer waiting times for surgery. Median time from radiological imaging to surgery was 51 days (Q1-3 27-191) for patients with low education, compared to 32 days (Q1-3 20-80) for patients with high education (p = 0.006). Differences in waiting time over educational levels remained significant after stratification for age, comorbidity, preoperative performance status, and tumor size. Overall survival was better for patients with high income or high education, but income- and education-related survival differences were not significant after adjustment for age and comorbidity. The type of surgical procedure or complications did not differ over socioeconomic groups or sex. CONCLUSION The neurosurgical care for LGG in Sweden, a society with universal healthcare, displays differences that can be related to socioeconomic factors.

中文翻译：

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社会经济因素影响低级神经胶质瘤患者的治疗效果：一项基于瑞典人群的研究。

背景技术尽管渴望在医疗保健领域实现平等，但我们知道存在社会经济差异并可能影响治疗和患者预后，甚至在诸如癌症等严重疾病中也是如此。我们调查了低度神经胶质瘤（LGG）患者在神经外科护理和预后方面的差异。方法在这项基于注册表的全国性研究中，通过瑞典脑肿瘤注册表对2005-2015年间接受LGG手术治疗的患者进行了鉴定（n = 547）。我们将数据与多个国家注册管理机构的收入，教育程度和合并症的个人水平数据关联起来，并分析了疾病特征，手术管理和结果与收入水平，教育程度和性别之间的关联。结果低收入，低学历或女性的患者表现出较差的术前状态。低收入或低学历的患者合并症也更多，低学历的患者忍受更长的手术等待时间。低学历患者从放射成像到手术的中位时间为51天（Q1-3 27-191），而高学历患者为32天（Q1-3 20-80）（p = 0.006）。在对年龄，合并症，术前表现状态和肿瘤大小进行分层后，超过教育水平的等待时间差异仍然很显着。高收入或高学历的患者的总生存期更好，但在调整年龄和合并症后，与收入和教育相关的生存期差异并不显着。手术程序或并发症的类型在社会经济群体或性别方面没有差异。结论瑞典LGG的神经外科护理