The Impact of Socioeconomic Status, Surgical Resection and Type of Hospital on Survival in Patients with Pancreatic Cancer. A Population-Based Study in The Netherlands

The influence of socioeconomic inequalities in pancreatic cancer patients and especially its effect in patients who had a resection is not known. Hospital type in which resection is performed might also influence outcome. Patients diagnosed with pancreatic cancer from 1989 to 2011 (n = 34,757) were...

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Veröffentlicht in:PloS one 2016-11, Vol.11 (11), p.e0166449-e0166449
Hauptverfasser: van Roest, Margijske H G, van der Aa, Maaike A, van der Geest, Lydia G M, de Jong, Koert P
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van der Aa, Maaike A
van der Geest, Lydia G M
de Jong, Koert P
description The influence of socioeconomic inequalities in pancreatic cancer patients and especially its effect in patients who had a resection is not known. Hospital type in which resection is performed might also influence outcome. Patients diagnosed with pancreatic cancer from 1989 to 2011 (n = 34,757) were selected from the population-based Netherlands Cancer Registry. Postal code was used to determine SES. Multivariable survival analyses using Cox regression were conducted to discriminate independent risk factors for death. Patients living in a high SES neighborhood more often underwent resection and more often were operated in a university hospital. After adjustment for clinicopathological factors, risk of dying was increased independently for patients with intermediate and low SES compared to patients with high SES. After resection, no survival difference was found among patients in the three SES groups. However, survival was better for patients treated in university hospitals compared to patients treated in non-university hospitals. Low SES was an independent risk factor for poor survival in patients with pancreatic cancer. SES was not an adverse risk factor after resection. Resection in non-university hospitals was associated with a worse prognosis.
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subjects Adult
Aged
Analysis
Biomarkers
Cancer
Cancer patients
Cancer research
Care and treatment
Chemotherapy
Classification
Disease
Female
Health care access
Health risk assessment
Health risks
Hospitals
Humans
Low income groups
Male
Medical diagnosis
Medicine and Health Sciences
Middle Aged
Mortality
Netherlands - epidemiology
Pancreas - surgery
Pancreatic cancer
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - surgery
Patient outcomes
Patients
People and Places
Population
Population studies
Population-based studies
Prognosis
Radiation therapy
Registries
Regression analysis
Risk analysis
Risk factors
Social Class
Social Sciences
Socioeconomic factors
Socioeconomic status
Socioeconomics
Studies
Surgery
Survival
Survival Analysis
title The Impact of Socioeconomic Status, Surgical Resection and Type of Hospital on Survival in Patients with Pancreatic Cancer. A Population-Based Study in The Netherlands
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