Impact of Sociodemographic Factors on Delayed Presentation in Neuro-Oncology Patients

Overview

This study analyzed 366 surgical neuro-oncology patients treated at a tertiary center in Mexico City in 2022, identifying key sociodemographic factors associated with delayed presentation and larger tumor volumes. Lower education, greater travel distance, and lower income were linked to more severe clinical presentations, highlighting disparities in access to timely neuro-oncologic care.

Background

Central nervous system (CNS) cancers cause significant morbidity and mortality globally, with Latin America, particularly Mexico, bearing a substantial burden. Patients often experience delays in diagnosis and treatment due to limited resources in rural areas, low educational levels, and financial constraints. The Instituto Nacional de Neurología y Neurocirugía (INNN) in Mexico City serves as a major referral center, receiving many patients from rural regions where neurosurgical expertise is scarce. Understanding sociodemographic factors influencing delayed presentation is critical to improving outcomes in this population.

Data Highlights

Key Findings

• Median symptom duration prior to presentation was 37 weeks, indicating significant delays in care.
• Lower education levels were associated with longer symptom duration and larger tumor volumes at presentation.
• Greater travel distance to the tertiary center correlated with delayed presentation and increased tumor size.
• Lower monthly income was linked to more severe clinical presentations, reflecting socioeconomic barriers.
• Nearly one-third of patients were primary family providers, potentially influencing healthcare-seeking behavior.

Clinical Implications

Clinicians should recognize that patients from rural areas with lower education and income levels are at higher risk for delayed neuro-oncologic presentation and advanced disease. Targeted interventions, including education, improved referral pathways, and transportation support, are needed to reduce delays and improve outcomes. Awareness of these sociodemographic factors can guide resource allocation and patient counseling.

Conclusion

Sociodemographic disparities significantly impact the timing and severity of neuro-oncology patient presentations in Mexico City. Addressing these factors is essential to enhance early diagnosis and optimize surgical outcomes in this vulnerable population.

References

1. Global Burden of Disease Cancer Collaboration 2020 -- Global cancer incidence and mortality
2. Instituto Nacional de Neurología y Neurocirugía (INNN) Reports 2022 -- Patient Referral Patterns
3. Mexican Ministry of Health 2019 -- Rural Healthcare Challenges
4. Mexican Medical Student Social Service Program 2022 -- Role in Data Collection