We aim to summarize the existing literature on health disparities in neuro-oncology in order to provide directions for future research and interventions. We discuss issues within neuro-oncology as they relate to primary central nervous system (CNS) tumors, brain metastases, and pediatric brain tumors. We also highlight issues of unequal representation in clinical trials and financial toxicity resulting from the high cost of treatment and associated unemployment. 

Health disparities in neuro-oncology span across the diagnosis, treatment, and outcomes of  central nervous system (CNS) tumors. The impact of financial toxicity, both from the high cost of treatment and loss of employment, as well as inadequate representation in clinical trials are targets for improvement and intervention.

Comprehensive review of the literature of health disparities in primary brain tumors, brain metastases, and pediatric neuro-oncology using PubMed and expert opinion. 

Based on a review of current literature, there are many health disparities within the field of neuro-oncology. For primary CNS tumors, minority populations face delays in diagnosis, lower rates of gross total resection and post-operative radiation, and more post-operative complications. Pediatric patients face additional issues with access to care and increased mortality. With respect to brain metastases, minorities have lower rates of indicated cancer screening, less access to advanced imaging, and less access to genetic testing. Financial toxicity, from the high cost of treatments and loss of employment, disproportionately affects minority populations. Historically marginalized populations are also underrepresented in clinical trials. 

As these disparities span multiple domains, successful interventions will need to utilize a multifaceted approach with diverse stakeholders and address the social, structural, and political determinants of health. 

Healthcare disparities are prevalent within neuro-oncology and affect outcomes related to primary CNS tumors, brain metastases, and pediatric brain tumors. Areas of intervention include mitigating financial toxicity and increasing diverse representation of participants in clinical research.