Elderly Medicare patients with low socioeconomic status are less likely receive pancreatic cancer treatment, according to a study published in The Oncologist.1
The optimal management of pancreatic cancer in elderly patients is undetermined. Elderly patients and patients of low socioeconomic status are, furthermore, underrepresented in clinical trials. For this study, researchers used Medicare and Surveillance, Epidemiology, and End Results (SEER) data to evaluate treatment trends, patient characteristics, and disease outcomes in this patient-group.
Of 5975 included patients, 85% were white, 55% were female, and 759 lived in an area where at least 20% of the population lived below the poverty level. Most (74%) patients presented with locoregional disease.
Patients were most likely to receive chemotherapy only (41%), followed by chemotherapy and surgery (30%), no treatment (16%), surgery only (10%), and radiation (3%). Patients aged 66 to 74 years with locoregional disease were most likely to have a survival benefit with surgery or surgery and chemotherapy. Patients aged at least 75 years with locoregional disease did not, however, appear to benefit from surgery with or without chemotherapy.
The adjusted odds ratio (OR) for receiving any treatment was 0.33 among patients living in an area where at least 20% of the population was below the poverty line. Patients with distant metastases were, furthermore, half as likely to receive treatment as those with locoregional disease (adjusted OR, 0.5).
The authors concluded that “greater efforts are required that focus on understanding the barriers and identifying the causes of disparities in care for elderly patients with pancreatic cancer.”
- Shaib WL, Jones JS, Goodman M, et al. Evaluation of treatment patterns and survival outcomes in elderly pancreatic cancer patients: a Surveillance, Epidemiology, and End Results‐Medicare analysis. Oncologist. 2018 Feb 14. doi: 10.1634/theoncologist.2017-0487 [Epub ahead of print]