Material deprivation linked to fewer days home after glioblastoma diagnosis

Adults diagnosed with glioblastoma in more materially deprived Ontario neighborhoods spent substantially fewer days at home during the first year after diagnosis, according to a population-based retrospective cohort study of 9,172 patients. The analysis found an adjusted median difference of 36.2 fewer days at home between residents of the most deprived neighborhoods and those in the least deprived areas, a gap of more than five weeks. The finding is an association and does not establish that neighborhood deprivation caused the shorter time at home.

Researchers linked Ontario administrative data for adults diagnosed with glioblastoma from 2003 through 2023, with the primary analysis including diagnoses through 2022. Neighborhoods were classified into five quintiles using the Ontario Marginalization Index, with Q1 representing the least materially deprived communities and Q5 the most deprived. The primary outcome was days at home within 365 days of diagnosis, defined as days alive outside acute hospitals, inpatient rehabilitation, and continuing or complex care. The measure therefore captured time at home among patients who remained alive, rather than simply the total length of time since diagnosis.

Among the 9,172 adults in the cohort, 4,491, or 49.0%, were younger than 65 years, while 5,435, or 59.3%, were male. Unadjusted median days at home varied sharply across the deprivation spectrum: 249 days in Q1, with an interquartile range of 67 to 350 days, compared with 138 days in Q5, with an interquartile range of 27 to 332 days. A median quantile regression used 8,234 complete cases and adjusted for age, sex, comorbidity, frailty, rurality and diagnosis year.

After adjustment, residents of Q2 had a median 8.8 fewer days at home than those in Q1, although the 95% confidence interval ranged from 19.6 fewer days to 2.0 more days and included no difference. The adjusted differences were larger and more precise in the three more deprived groups: 14.8 fewer days for Q3, with a 95% confidence interval of 27.0 fewer to 2.6 fewer; 18.3 fewer days for Q4, ranging from 29.4 fewer to 7.2 fewer; and 36.2 fewer days for Q5, ranging from 51.5 fewer to 20.9 fewer. Secondary analyses examined other periods of days at home and overall survival.

Overall survival also differed between the least and most deprived groups. Median survival was 324 days in Q1, with a 95% confidence interval of 306 to 343 days, compared with 225 days in Q5, with a 95% confidence interval of 211 to 244 days. Because the study was observational and relied on linked administrative records, it could not determine whether the association arose from differences in treatment access, discharge planning, supportive care, housing or social circumstances, disease characteristics, or other factors not fully captured by the adjustment variables. The authors said the adjusted gap exceeding five weeks warrants investigation of treatment access and supportive-care pathways as potential targets for improving equity.

Subject of Research: Association between neighborhood material deprivation, days at home and survival after glioblastoma diagnosis

Article Title: Neighborhood material deprivation and days at home after glioblastoma diagnosis

Article References: Saini, J., Lozano, C., Karthikeyan, V., Shakil, H., Malhotra, A. K., He, Y., Sykes, J., Lim-Fat, M. J., Badhiwala, J., Wilson, J. R., & Alli, S. B. (2026). Neighborhood material deprivation and days at home after glioblastoma diagnosis. Journal of Neuro-Oncology, 180(2), Article 28. https://doi.org/10.1007/s11060-026-05843-6

Image Credits: AI Generated

DOI: 10.1007/s11060-026-05843-6

Keywords: glioblastoma, material deprivation, health equity, days at home, Ontario, survival, population-based cohort, administrative data, supportive care, Neighborhood, material, deprivation