The reality of pancreas cancer care from access to delivery.

Academic Article

Abstract

  • 241 Background: Prior literature has identified significant demographic differences in surgically treated patients with pancreas cancer (PC). Therefore, we hypothesized that disparities in socio-demographics exist in critical parameters throughout the continuum of PC care. METHODS: We compiled a retrospective cohort of AJCC Stage I-IV PC from the California Cancer Registry. We used logistic regression to study sociodemographics as predictors of: 1) resectability at diagnosis or treatment (defined as absence of pre- or postoperative features of advanced or metastatic disease), 2) undergoing pancreatectomy, and 3) receipt of adjuvant chemotherapy (with/without radiotherapy) after surgery, while adjusting for confounders. RESULTS: Of 20,312 patients with PC (1994-2008), 37% presented with resectable disease. Of those, only 40% received pancreatectomy. At multivariate analysis, race did not predict resectability, yet independently predicted undergoing pancreatectomy and receiving adjuvant therapies. Whites were 1.5 times as likely as blacks to undergo pancreatectomy and, following surgery, were more likely to receive chemotherapy with or without radiotherapy (for all, p <0.01). Blacks were more likely to carry Medicaid than whites (10% vs. 5%, p<0.01). Compared to those with other insurances, Medicaid recipients showed lower odds of undergoing pancreatectomy (Table). CONCLUSIONS: Our results suggest that race and insurance continue to influence the continuum of optimal PC care. Going forward, further policies and research should identify effective strategies to neutralize disparities in PC care. [Table: see text] No significant financial relationships to disclose.
  • Published In

    Pubmed Id

  • 8228229
  • Author List

  • Abraham AA; Al-Refaie WB; Parsons HM; Dudeja V; Vickers SM; Habermann EB
  • Start Page

  • 241
  • Volume

  • 29
  • Issue

  • 4_suppl