Disparities in Brain Metastases Diagnosis and Treatment Patterns in Non-Small Cell Lung Cancer Patients

A study examining brain metastases among patients with metastatic non-small cell lung cancer (mNSCLC) reveals disparities in diagnosis and treatment patterns, particularly in high poverty areas. Data from the Surveillance, Epidemiology, and End Results (SEER) program linked to Medicare claims were used to examine the prevalence of brain imaging at diagnosis among Medicare beneficiaries with mNSCLC. The study found that 21.4% of patients had known brain metastases at diagnosis, with a higher prevalence in younger age groups and lower prevalence in high poverty areas.

Key Takeaways:

21.4% of patients with mNSCLC had known brain metastases at diagnosis, while 27.3% did not receive diagnostic brain imaging.
Patients in high poverty areas were less likely to receive brain imaging (odds ratio [OR] 0.664, P < 0.001) or first-line systemic therapy (OR 0.580, P < 0.001) compared to patients in low poverty areas.
The prevalence of brain metastases at diagnosis decreased with increasing age (25.6% in 65-74 year-olds, 19.6% in 75-84 year-olds, and 9.4% in 85-100 year-olds).
Diagnostic brain imaging was performed less frequently in older age groups.

Statistics:

21.4% of patients with mNSCLC had known brain metastases at diagnosis.
27.3% of patients did not receive diagnostic brain imaging.
25.6% of patients in the 65-74 age group had brain metastases at diagnosis.
19.6% of patients in the 75-84 age group had brain metastases at diagnosis.
9.4% of patients in the 85-100 age group had brain metastases at diagnosis.
Patients in high poverty areas were 0.664 times more likely to not receive brain imaging (P < 0.001) and 0.580 times more likely to not receive first-line systemic therapy (P < 0.001).

Sources:

Imaging Utilization and Treatment Patterns of Brain Metastases in Patients With Non-Small Cell Lung Cancer: A SEER-Medicare and SEER Database Analysis (Clinical Lung Cancer, 2025)