Racial differences in cancer specialist consultation, treatment, and outcomes for locoregional pancreatic adenocarcinoma
Department of Surgery; Senior Scholars Program
Medical Subject Headings
Adenocarcinoma; African 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
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.
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Citation: Ann Surg Oncol. 2009 Nov;16(11):2968-77. Epub 2009 Aug 11. Link to article on publisher's site
Murphy, Melissa M.; Simons, Jessica P.; Ng, Sing Chau; McDade, Theodore P.; Smith, Jillian K.; Shah, Shimul A.; Zhou, Zheng; Earle, Craig C.; and Tseng, Jennifer F., "Racial differences in cancer specialist consultation, treatment, and outcomes for locoregional pancreatic adenocarcinoma" (2009). Surgery Publications and Presentations. 63.