Survival Among Patients with Glioma in the US Military Health System: A Comparison with Patients in the Surveillance, Epidemiology, and End Results Program

Overview

Journal Cancer

Publisher Wiley

Specialty Oncology

Date 2020 Apr 15

PMID 32286688

Citations 4

Authors

Jie Lin

Julie A Bytnar

Brett J Theeler

Katherine A McGlynn

Craig D Shriver

Kangmin Zhu

Affiliations

Soon will be listed here.

Abstract

Background: Glioma is the most common malignant brain cancer. Accessibility to health care is an important factor affecting cancer outcomes in the US general population. The US Military Health System (MHS) provides universal health care to its beneficiaries. It is unknown whether this universal health care has translated into improved survival outcomes among MHS beneficiaries with glioma. This study compared the overall survival of patients with glioma in the MHS with the overall survival of patients with glioma in the general population.

Methods: The MHS cases were identified from the Department of Defense's Automated Central Tumor Registry (ACTUR). Glioma cases from the general population were identified from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. SEER cases were matched 2:1 to ACTUR cases by age, sex, race, histology, and diagnosis year. All cases had histologically confirmed glioma diagnosed between January 1, 1987, and December 31, 2013. A Kaplan-Meier analysis was conducted to compare survival between the ACTUR and SEER cases. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: The study included 2231 glioma cases from ACTUR and 4462 cases from SEER. ACTUR cases exhibited significantly better overall survival than SEER cases (HR, 0.74; 95% CI, 0.67-0.83). The survival advantage of the ACTUR patients was observed in most subgroups stratified by age, sex, race, diagnosis year, and histology. For glioblastoma, the survival advantage was observed in both the pre- and post-temozolomide periods.

Conclusions: Universal MHS health care may have translated into improved survival outcomes in glioma. Future studies are warranted to identify factors contributing to the improved survival.

Citing Articles

Prevalence and risk factors of early postoperative seizures in patients with glioma: a systematic review and meta-analysis.

Sun B, Sun Y, Wang Z, Zhao C, Yang L Front Neurol. 2024; 15:1356715.

PMID: 38572493 PMC: 10989274. DOI: 10.3389/fneur.2024.1356715.

MilCanEpi: Increased Capability for Cancer Care Research in the Department of Defense.

Eaglehouse Y, Shriver C, Lin J, Bytnar J, Darmon S, McGlynn K JCO Clin Cancer Inform. 2023; 7:e2300035.

PMID: 37582239 PMC: 10569781. DOI: 10.1200/CCI.23.00035.

Five-year survival of patients with late-stage prostate cancer: comparison of the Military Health System and the U.S. general population.

Lin J, Nousome D, Jiang J, Chesnut G, Shriver C, Zhu K Br J Cancer. 2023; 128(6):1070-1076.

PMID: 36609596 PMC: 10006403. DOI: 10.1038/s41416-022-02136-3.

Soft-tissue Sarcoma Survival in the US Military Health System: Comparison With the SEER Program.

Anderson A, Park A, Zhu K, Lin J, Shriver C, Potter B J Am Acad Orthop Surg Glob Res Rev. 2022; 6(6).

PMID: 35727910 PMC: 10566816. DOI: 10.5435/JAAOSGlobal-D-22-00122.

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