2025 Poster Presentations
P222: SOCIOECONOMIC DISPARITIES IN PITUITARY ADENOMAS OUTCOMES
Ross S Rosen1; John Richter1; Daniel Karasik1; Rishi Katragadda2; Claudia I Cabrera, MD1; Kenneth Rodriguez, MD1; Sanjeet V Rangarajan, MD1; Brian D'Anza, MD1; 1University Hospitals Cleveland Medical Center Department of Otolaryngology-Head and Neck Surgery; 2Case Western Reserve University School of Medicine
Background: Pituitary adenomas represent about 10-15% of all intracranial masses. Despite nearly all pituitary tumors being benign adenomas, they can result in serious long-term complications due to their proximity to nearby structures and effects on hormonal function. Treatment often consists of surgery or medical therapy. Socioeconomic disparities regarding incidence and treatment of pituitary adenomas have been identified previously. Factors such as female gender, black race, low income, and urban residency are all associated with higher incidence. Similarly, females, black patients, and those with government insurance or no insurance were more likely to be recommended against surgery. Our group aims to measure differences in relative overall survival rates between socioeconomic groups of patients with pituitary adenomas.
Methods: The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients diagnosed with pituitary adenomas using the November 2023 submission on data from 2000-2021. Demographics were evaluated as follows: categorical variables such as gender, race/ethnicity, and location were analyzed using univariate chi square tests, while quantitative variables such as income were analyzed with linear regression, to determine their association with relative survival rates.
Results: We identified 72,763 patients with pituitary adenomas during this time frame. On univariate analysis, female gender (97.2%, CI95% 96.9%-97.5%), white race (97.1%, CI95% 96.8%-97.5%), Hispanic ethnicity (97.3%, CI95% 96.8%-97.7%), and residence in a large metropolitan area (>1 million residents, 97.3%, CI95% 97.0%-97.6%) were all significantly associated with improved 5-year relative survival. Male gender (96.5%, CI95% 96.1%-96.9%), black race (95.7%, CI95% 95.0%-96.3%), and rural (95.3%, CI95% 93.7%-96.5%) or suburban (95.8%, CI95% 94.5%-96.8%) residence were associated with poorer 5-year relative survival. Regarding household income, there was a positive correlation between income and 5-year relative survival (r=0.83).
Conclusions: This study highlights the presence of several disparities in relative overall survival after diagnosis of pituitary adenoma based on demographic and socioeconomic variables. While these differences are small, they warrant further investigation to determine if they represent true disparities in care or are due to other factors related to disease progression or patient characteristics. Additional research is needed to understand the root causes of these differences and to ensure equitable management of pituitary adenomas across all demographic groups.