本研究的目的是评估患有脑转移性恶性肿瘤的成年人在发病率、治疗和生存方面的人口和种族差异。利用监测、流行病学和最终结果 (SEER) 计划数据库，作者确定了患有非原发性脑转移的成年人2010 年至 2019 年之间的转移。计算所有 10 年的发病率，同时使用 2010 年至 2014 年的数据进行生存分析。主要结局指标是 5 年内的全因死亡率，通过 6 个月、1 年、2 年和 5 年生存率进行评估。使用独立卡方检验和单因素方差分析分别比较非西班牙裔白人 (NHW)、西班牙裔白人 (HW)、黑人和亚洲/太平洋岛民 (API) 患者之间的分类和连续测量。开发了多变量 Cox 比例风险模型来评估 5 年内的死亡风险。根据年龄（排除> 84 岁或 < 18 岁的患者被排除）、缺少种族数据、以及缺失的生存数据。每 100,000 名成年人中就有报告发病率。脑转移的发病率从2010年的2.59上升到2019年的2.78，平均10年发病率为2.72。 API 患者的人群调整发病率最高 (3.52)，其次是 NHW (2.99)、黑人 (2.32) 和 HW (1.59) 患者。黑人患者最有可能具有低收入和单身状态，而 API 患者最有可能具有高收入和已婚状态。随后，黑人患者的生存时间最短（NHW 为 9.05 个月，HW 为 9.19 个月，HW 为 12.93 个月，API 患者为 15.89 个月，p < 0.001）。在控制了社会经济因素对生存的影响后，多变量分析显示，Black（HR 0.91，95% CI 0.88-0.94）、HW（HR 0.73，95% CI 0.69-0.76）和 API（HR 0.69，95% CI） CI 0.66-0.73）患者与 NHW 患者相比均具有生存优势。手术还带来了强大的生存优势（HR 0.47，95% CI 0.44-0.49）。2010年至2019年间，脑转移的发生率略有增加，其中API患者的发生率最高。黑人患者的生存率最低，可能是由于社会经济地位较差以及手术和化疗率较低。黑人患者最有可能不被推荐接受手术，这表明为这些患者提供的服务存在差异。需要进行更多研究来了解这些差异的根本原因。

The aim of this study was to assess demographic and racial disparities in incidence, treatment, and survival of adults with metastatic malignancy to the brain.Using the Surveillance, Epidemiology, and End Results (SEER) Program database, the authors identified adults with nonprimary brain metastases between 2010 and 2019. Incidence was calculated for all 10 years while data from 2010 to 2014 were used for survival analysis. The primary outcome measure was all-cause mortality within 5 years, assessed by 6-month, 1-year, 2-year, and 5-year survival rates. Chi-square tests of independence and one-way ANOVA were used to compare categorical and continuous measures, respectively, between non-Hispanic White (NHW), Hispanic White (HW), Black, and Asian/Pacific Islander (API) patients. A multivariable Cox proportional hazards model was developed to evaluate the risk of death within 5 years.A total of 64,690 patient records were identified and analyzed following exclusion based on age (patients > 84 years or < 18 years were excluded), missing race data, and missing survival data. Incidences are reported per 100,000 adults. The incidence of brain metastases increased from 2.59 in 2010 to 2.78 in 2019, with an average 10-year incidence of 2.72. API patients had the highest population-adjusted incidence (3.52), followed by NHW (2.99), Black (2.32), and HW (1.59) patients. Black patients were the most likely to have low income and single status, while API patients were the most likely to have high income and married status. Subsequently, Black patients had the shortest survival time (9.05 months vs 9.19 months for NHW vs 12.93 months for HW vs 15.89 months for API patients, p < 0.001). After controlling for the effect of socioeconomic factors on survival, the multivariable analysis showed that Black (HR 0.91, 95% CI 0.88-0.94), HW (HR 0.73, 95% CI 0.69-0.76), and API (HR 0.69, 95% CI 0.66-0.73) patients all had a survival advantage compared with NHW patients. Surgery also conferred a strong survival advantage (HR 0.47, 95% CI 0.44-0.49).The incidence of brain metastases has increased slightly between 2010 and 2019, with the highest rate in API patients. Black patients had the lowest survival, potentially due to poor socioeconomic status and lower rates of surgery and chemotherapy. Black patients were the most likely to not be recommended surgery, suggesting a discrepancy in services offered to these patients. More research is warranted to understand the underlying causes of these disparities.