Are patients of low socioeconomic status receiving suboptimal management for pancreatic adenocarcinoma?

BACKGROUND: The objective of this study was to define the effects of socioeconomic status (SES) and other demographic variables on outcomes for patients with pancreatic adenocarcinoma. METHODS: Florida cancer registry and inpatient hospital data were queried for pancreatic adenocarcinoma diagnosed f...

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Bibliographic Details
Published in:Cancer 2010-02, Vol.116 (3), p.723-733
Main Authors: Cheung, Michael C., Yang, Relin, Byrne, Margaret M., Solorzano, Carmen C., Nakeeb, Attila, Koniaris, Leonidas G.
Format: Article
Language:English
Subjects:
Adenocarcinoma - economics
Adenocarcinoma - mortality
Adenocarcinoma - therapy
Adult
Aged
Biological and medical sciences
Comorbidity
Female
Florida
Gastroenterology. Liver. Pancreas. Abdomen
Healthcare Disparities
Humans
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
outcomes
pancreatic cancer
Pancreatic Neoplasms - economics
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - therapy
Poverty
racial disparities
Social Class
socioeconomic status
Tumors
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Summary:BACKGROUND: The objective of this study was to define the effects of socioeconomic status (SES) and other demographic variables on outcomes for patients with pancreatic adenocarcinoma. METHODS: Florida cancer registry and inpatient hospital data were queried for pancreatic adenocarcinoma diagnosed from 1998 to 2002. RESULTS: In total, 16,104 patients were identified. Low SES (LSES) patients were younger at diagnosis (P < .001) but presented with similar disease stage and tumor grade. LSES patients were less likely to receive surgical extirpation (16.5% vs 19.8%; P < .001), chemotherapy (30.7% vs 36.4%; P < .001), or radiotherapy (14.3% vs 16.9%; P = .003). Among surgical patients, 30‐day mortality was significantly higher (5.1% vs 3.7%; P < .001) and overall median survival was significantly worse (5.0 months vs 6.2 months; P < .001) in the LSES cohorts. Although surgical patients who were treated at teaching facilities (TF) did significantly better; an increased 30‐day surgical mortality (2.2% vs 1.3%; P < .001) and decreased median survival (5 months for poverty level >15% vs 6.2 months for poverty level
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.24758