Introduction: Los Angeles, California (CA) is home to approximately 4 million individuals of diverse racial and ethnic origins. According to the United States Census Bureau, 48.4% of Angelenos identify as Hispanic or Latino, while 9.1% identify as Black or African American. Moreover, persons without health insurance, under the age of 65 years, account for 17.4% of the population. The objective of the study is to shed light on racial disparities amid Hispanic and African American adult brain tumor patients treated at a Los Angeles County (LAC) academic neurosurgery service as compared to the general Angeleno population.

Methods: A retrospective review of patients admitted to the neurosurgery service at Harbor-UCLA Medical Center (Torrance, CA) during years 2006 through 2010 was performed. Brain tumor diagnoses were ascertained through the medical record. Government census data was queried and pertinent national statistics were retrieved. Populations at Harbor-UCLA were compared against LAC and Torrance, CA using independent Student’s t tests.

Results: A total of 271 patients were included in the study. The mean age was 46.9 years. Hispanics comprised the majority of neurosurgical patients (n = 151, 55.7%), followed by African Americans (n = 35, 12.9%). A total of 220 patients had final histopathological diagnoses. The most common diagnoses were gliomas (n = 58, 26.3%), meningiomas (n = 57, 25.9%), and metastases (n = 28, 12.7%). A greater percentage of Hispanic patients were treated at Harbor-UCLA relative to the general Hispanic populations of LAC and Torrance (p < 0.001). A greater percentage of African American patients were treated at Harbor-UCLA relative to the general African American populations of LAC and Torrance (p = 0.035 and p < 0.001, respectively).

Conclusions: Our data revealed significant racial disparities amid the Harbor-UCLA Hispanic and African American patient populations compared to the general Angeleno populations of LAC and Torrance.

Patient Care: The research herein described highlights important socioeconomic and cultural issues that have the potential to impact the delivery of specialized neurosurgical care to adult brain tumor patients at county academic teaching hospitals.

Learning Objectives: To appreciate differences in patient demographics and tumor distributions among Hispanic and African American adult brain tumor patients treated at a county academic neurosurgery service compared to the populations of LAC and residents of Torrance.

References: [1] Mukherjee D, Zaidi HA, Kosztowski T, Chaichana KL, Brem H, Chang DC, et al. Disparities in access to neuro-oncologic care in the United States. Arch Surg. 2010;145:247-53. [2] Shabihkhani M, Telesca D, Movassaghi M, Naeini YB, Naeini KM, Hojat SA, et al. Incidence, survival, pathology, and genetics of adult Latino Americans with glioblastoma. J Neurooncol. 2017. [3] Trinh VT, Davies JM, Berger MS. Surgery for primary supratentorial brain tumors in the United States, 2000-2009: effect of provider and hospital caseload on complication rates. J Neurosurg. 2015;122:280-96. [4] Dasenbrock HH, Liu KX, Devine CA, Chavakula V, Smith TR, Gormley WB, et al. Length of hospital stay after craniotomy for tumor: a National Surgical Quality Improvement Program analysis. Neurosurg Focus. 2015;39:E12. [5] Barnholtz-Sloan JS, Maldonado JL, Williams VL, Curry WT, Rodkey EA, Barker FG, 2nd, et al. Racial/ethnic differences in survival among elderly patients with a primary glioblastoma. J Neurooncol. 2007;85:171-80. [6] Drazin D, Lagman C, Bhargava S, Nuño M, Kim TT, Johnson JP. National trends following decompression, discectomy, and fusion in octogenarians and nonagenarians. Acta Neurochir (Wien). 2017. [7] Nuno M, Drazin DG, Acosta FL, Jr. Differences in treatments and outcomes for idiopathic scoliosis patients treated in the United States from 1998 to 2007: impact of socioeconomic variables and ethnicity. Spine J. 2013;13:116-23. [8] Ayoubi S, Dunn IF, Al-Mefty O. Meningiomas. Brain Tumors An Encyclopedic Approach. 3rd ed: Saunders; 2011. p. 600-29. [9] Sarkar A, Chiocca AE. Glioblastoma and malignant astrocytoma. Brain Tumors An Encyclopedic Approach. 3rd ed: Saunders; 2011. p. 384-407.