• Ignacio Jusue-Torres, Alicia Hulbert, Jehad Zakaria, Kathy S Albain, Courtney L Hentz, Edward Melian, Jigisha P Thakkar, and Vikram C Prabhu.
• Department of Neurological Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois, USA. Electronic address: ignacio.jusuetorres@lumc.edu.
• World Neurosurg. 2021 Oct 1; 154: e236-e244.

Objective/BackgroundThe purpose of this study was to characterize the impact of household income disparities in the survival of patients with non-small cell lung cancer (NSCLC) presenting with brain metastasis on a population-based level.MethodsThis is a population-based cohort study using the Surveillance, Epidemiology, and End Results (SEER) database from 2010-2016 including 15,808 NSCLC patients presenting with brain metastasis.ResultsThis study comprises 15,808 adult patients with NSCLC presenting with brain metastases having an age range 64 ± 10 years with 51% male, 76% white, 52% married, 61% insured, and with 85% of lung adenocarcinoma histopathology. The 1-, 2- and 5-year survival rates for living in the lower household income quartile were 21%, 10%, and 3%, respectively, for the second quartile 24%, 10%, and 3%; for the third quartile 28%, 14%, and 4%; and for the top quartile 31%, 17%, and 4%, respectively. Multivariate Cox proportional hazard analysis showed that living in a higher quartile household income county is associated with increased survival (P < 0.0001), hazard ratio 0.87, 95% confidence interval (0.82-0.92).ConclusionsThis population-based study suggests that living in higher median household income counties is associated with increased survival time and reduced risk of mortality for patients with NSCLC who have brain metastases present at diagnosis, independent of other factors. These findings underscore the importance of ensuring adequate and easy access to care for all patients, irrespective of their economic background.Copyright © 2021 Elsevier Inc. All rights reserved.

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