2025 Proffered Presentations
S268: ASSESSING DISPARITIES IN SURGICAL RECOMMENDATIONS FOR VESTIBULAR SCHWANNOMA PATIENTS: A STUDY USING THE SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS DATABASE FROM 2000-2019
Adrian Li; Melanie Horowitz; Saket Myneni; Julian Gendreau; Debraj Mukherjee; Department of Neurosurgery, Johns Hopkins School of Medicine
Introduction: Factors that influence surgical intervention recommendations for vestibular schwannoma patients have not been thoroughly investigated. This study examines racial and socioeconomic disparities in the treatment of vestibular schwannoma patients.
Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) Registry were used to identify all patients >18 years of age diagnosed with vestibular schwannoma between 2000-2019. Univariable and multivariable logistic regressions were used to calculate odds ratios (OR) for variables linked to the likelihood of receiving a surgical recommendation and likelihood of undergoing surgery.
Results: We identified 27,658 patients with vestibular schwannoma (mean age ± SD: 55 ± 16 years, 51.4% female, 73.6% non-Hispanic White). Among them, 48.7% received a surgical recommendation.
In multivariable models, identifying as Asian/Pacific Islander (OR: 1.09, p=0.034) and having Hispanic ethnicity (OR: 1.12, p=0.010) were associated with increased odds of receiving surgical recommendations. Older age (OR: 0.96, p<0.001), higher median household income (OR: 0.81, p<0.001), and identifying as African American (OR: 0.80, p=0.002) were associated with decreased odds of receiving surgical recommendations.
Conclusions: For patients with acoustic neuroma, surgical recommendations are influenced by race, income, and Hispanic ethnicity. African American patients are less likely to receive surgical recommendations, while Asian/Pacific Islander and Hispanic patients are more likely compared to non-Hispanic White patients. Additionally, patients with higher median household incomes are less likely to receive surgical recommendations. The effect resulting in such disparity remains unclear. Efforts to identify and address disparities in surgical recommendations and promote health equity in this patient population are necessary.