Despite the strong association between surgical resection of early-stage pancreatic cancer and improved survival, a newly published study has found that African American, Hispanic, single, and uninsured patients were significantly less likely to have their tumors removed.1
The study, conducted by Jason S. Gold, MD, of Harvard Medical School and the VA Boston Healthcare System and colleagues, looked at whether socioeconomic variables including race, ethnicity, marital status, insurance status, and geographic location were associated with disparities in the utilization of surgical resection as a treatment for early-stage pancreatic cancer. It also examined whether those variables were independently associated with disease-specific survival in patients who did undergo resection.
The retrospective cohort analysis of 17 530 patients with localized, nonmetastatic pancreatic cancer diagnosed between January 1, 2004, and December 31, 2011, found an increased likelihood of resection in patients who were male (odds ratio [OR] = 1.20; 95% CI, 1.13 – 1.27); younger (OR = 0.95; 95% CI, 0.94 – 0.95); white (OR = 1.16; 95% CI, 1.08 – 1.26) or non-African American (for African American, OR = 0.80; 95% CI, 0.73 – 0.88); non-Hispanic (for Hispanic, OR = 0.83; 95% CI, 0.74 – 0.93); married (OR = 1.78; 95% CI, 1.67 – 1.89); or located in the Northeast (OR = 1.62; 95% CI, 1.50 – 1.76; all P < .001).
“Our research further confirmed that, as expected, resection is associated with improved survival,” the study’s authors wrote.
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Specifically, they found that the median disease-specific survival of patients who underwent resection was 21 months (95% CI, 20.3 -21.7); the median disease-specific survival of patients who did not was 6 months (95% CI, 5.8 – 6.2).
“Sex, race, ethnicity, marital status, and insurance status were not independently associated with disease-specific survival after resection,” they noted.