The deleterious effect of WHO grade II diffuse glioma on socioeconomic status as evaluated through occupation

Abstract

Abstract Although previous studies have evaluated return-to-work status following low-grade glioma (LGG) treatment, there is a paucity of detailed data on the nature of the occupation a patient returns to. The aim of this study was to describe the socioeconomic status of patients with WHO grade II diffuse glioma over long-term follow up and whether it changed following the LGG diagnosis. In addition, cognitive, education, and quality of life profiles, as well as estimated premorbid intelligence, were evaluated to explore the possibility of relationships with socioeconomic status. Twenty-one individuals with a histological diagnosis of WHO grade II diffuse glioma were recruited prospectively from a single UK center and completed questionnaires evaluating general health, socioeconomics, education, quality of life, and a battery of validated cognitive tests. Socioeconomic status was evaluated through an occupational-based classification. Forty percent of participants in the most advantaged socioeconomic group prior to the diagnosis of a glioma did not remain in the same advantaged group at the point of recruitment into the study. This is despite no marked cognitive impairments across the cohort and no significant cognitive differences between those who did and did not remain in this advantaged group. Attainment of a university-level qualification was significantly associated with maintenance of socioeconomic advantage following the LGG diagnosis, which may be explained by the concept of cognitive reserve. In conclusion, there are profound deleterious socioeconomic effects of LGG and its treatment. Educational attainment may be protective. Early tailored and proactive professional support regarding work-related issues is required for this patient group.