Association between sociodemographic variables and delayed patient presentation among surgical neuro-oncology patients in Mexico City: a single institution experience

Abstract

Purpose Mexico has the second highest incidence of central and peripheral nervous system cancer cases in Latin America, but clinical and research resources to improve oncologic care are biased towards high-income countries. We carried out a retrospective study to identify sociodemographic factors associated with more severe clinical presentation among surgical neuro-oncology who underwent surgery at a major public referral hospital in Mexico City. Methods The hospital electronic medical record was reviewed to identify all surgical neuro-oncology patients who underwent surgery between January 1 and December 31, 2022. Descriptive statistics were used to characterize the patient population and outcomes; statistical analysis was performed to determine association between sociodemographic variables and advanced clinical presentation. Results A total of 366 neuro-oncology patients underwent surgery during the study period. The median patient age was 48 (IQR 17–83). The majority of patients were female (60.1, n = 220), single (51.4%, n = 188), and 29.2% (n = 107) endorsed being the primary provider for their family. The median number of dependents per patient was 4 (IQR 2–50), while the median monthly income was 10269 Mexican pesos (MXN) (IQR 2000–13500] and the median travel distance to INNN was 49 km (IQR 22–174). On multivariate analyses, having a higher number of dependents was associated with increased odds of presenting with longer symptom duration (p = 0.01). Divorced/separated status was associated with increased odds of presenting with tumors > 35mL in volume (p = 0.04). Primary provider (p = 0.01) and higher average monthly income (p = 0.03) was associated with decreased odds of presenting with tumors > 35mL. Conclusions This is the first study to recognize that certain sociodemographic factors are associated with more severe clinical presentation among surgical neuro-oncology patients. Further studies are needed in order to decern specific causes for delayed presentation in this patient population in order to create targeted interventions and decrease delays in care.