Characterizing Disparities in Access to Surgery for Pituitary Adenomas: A National Cancer Database Analysis
Authors' conclusion
There are significant racial and socioeconomic disparities in access to HVFs for adult patients seeking surgical resection of pituitary adenomas.
Study context
- Population
- Patients with pituitary adenomas, National Cancer Database, United States, 2004–2019
- Participants
- 57,807 patients
- Exposure
- Surgery at high-volume facilities (HVFs) by race, ethnicity and socioeconomic factors
- Outcome
- Baseline description of patients treated at HVFs, survival outcomes, and predictors of survival
Methodological detailsNational Cancer Database, multivariable analysis
- National Cancer Database
- Multivariable analysis
Main finding
As reported in the abstract
Odds of surgery at a HVF (multivariable)
- African-American vs Caucasian
- OR 0.89; P < 0.001
- Hispanic vs Caucasian
- OR 0.80; P < 0.001
- Rural vs Urban
- OR 0.79; P = 0.003
- Medicaid vs Private
- OR 0.86; P < 0.001
- Income <$40 227 vs ≥$63 333
- OR 0.93; P = 0.049
- No high school graduation ≥17.6% vs <6.3%
- OR 0.95; P < 0.001
- Underwent surgery at a HVF
- 47.6% (n = 27 523)
Observational data: associations, not effects.
Further findings
Trend in access to surgery at HVFs over time
| OR (CI) | P value | ||
|---|---|---|---|
| 2005 | 1.10 (0.97–1.26) | P = 0.173 | |
| 2019 | 1.27 (1.13–1.43) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
- Increasing trend in access to surgical care at HVFs over time
Original publication
Characterizing Disparities in Access to Surgery for Pituitary Adenomas: A National Cancer Database Analysis. J Clin Endocrinol Metab. Published 2 April 2025. doi:10.
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