Racial differences in cancer specialist consultation, treatment, and outcomes for locoregional pancreatic adenocarcinoma
Authors
Murphy, Melissa M.Simons, Jessica P.
Ng, Sing Chau
McDade, Theodore P.
Smith, Jillian K.
Shah, Shimul A.
Zhou, Zheng
Earle, Craig C.
Tseng, Jennifer F.
Document Type
Journal ArticlePublication Date
2009-11-01Keywords
AdenocarcinomaAfrican Americans
Aged
European Continental Ancestry Group
Female
Healthcare Disparities
Humans
Kaplan-Meier Estimate
Male
Medical Oncology
Neoplasm Staging
Pancreatic Neoplasms
Prognosis
Referral and Consultation
Registries
SEER Program
Specialization
Survival Rate
Treatment Outcome
United States
Health Services Administration
Health Services Research
Oncology
Surgery
Metadata
Show full item recordAbstract
BACKGROUND: Blacks have a higher incidence of pancreatic adenocarcinoma and worse outcomes compared to whites. Identifying barriers in pancreatic cancer care may explain survival differences and provide areas for intervention. METHODS: Pancreatic adenocarcinoma patients were identified in the Surveillance, Epidemiology, and End Results Registry (1991-2002). Treatment and outcome data were obtained from the linked Surveillance, Epidemiology, and End Results Registry-Medicare databases. Logistic regression was used to assess race as a predictor of specialist consultation/receipt of therapy. Kaplan-Meier survival curves were compared. Cox proportional hazard analyses were performed to estimate survival after adjustment for patient and treatment characteristics. RESULTS: A total of 13,230 white patients (90%) and 1478 black patients (10%) were identified. Clinical/pathologic factors were compared by race. When we compared whites and blacks by univariate analyses, blacks had lower rates of specialist consultation (P CONCLUSIONS: Racial disparities exist in pancreatic cancer specialist consultation and subsequent therapy use. Because receipt of care is fundamental to reducing outcome discrepancies, these barriers serve as discrete intervention points to ensure all locoregional pancreatic adenocarcinoma patients receive appropriate specialist referral and subsequent therapy.Source
Ann Surg Oncol. 2009 Nov;16(11):2968-77. Epub 2009 Aug 11. Link to article on publisher's siteDOI
10.1245/s10434-009-0656-5Permanent Link to this Item
http://hdl.handle.net/20.500.14038/49789PubMed ID
19669839Notes
Jillian Smith participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1245/s10434-009-0656-5