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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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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A Population-Based Study in The Netherlands</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>van Roest, Margijske H G ; van der Aa, Maaike A ; van der Geest, Lydia G M ; de Jong, Koert P</creator><contributor>Ahmad, Aamir</contributor><creatorcontrib>van Roest, Margijske H G ; van der Aa, Maaike A ; van der Geest, Lydia G M ; de Jong, Koert P ; Ahmad, Aamir</creatorcontrib><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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0166449</identifier><identifier>PMID: 27832174</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2016-11, Vol.11 (11), p.e0166449-e0166449</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 van Roest et al. 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Resection in non-university hospitals was associated with a worse prognosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biomarkers</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Classification</subject><subject>Disease</subject><subject>Female</subject><subject>Health care access</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Low income groups</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Netherlands - epidemiology</subject><subject>Pancreas - surgery</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - diagnosis</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and Places</subject><subject>Population</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Registries</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Social Class</subject><subject>Social Sciences</subject><subject>Socioeconomic factors</subject><subject>Socioeconomic status</subject><subject>Socioeconomics</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1trFDEUgAdRbK3-A9FAQRTcNZe5vgi1qF0otnRXX0Mmc7KbMjsZk0y1v8i_6Rm7LbvShzIPc3LynUvOJUleMjplomAfLt3gO9VOe9fBlLI8T9PqUbLPKsEnOafi8Za8lzwL4ZLSTJR5_jTZ40UpOCvS_eTPYgVktu6VjsQZMnfaOtCuc2uryTyqOIT3ZD74pdWqJRcQQEfrOqK6hiyuexiNTlzobcRr1CN6Za9Qth05V9FCFwP5ZeMKT532gCpNjlEEPyVH5Nz1Q6tGj5NPKkCDIYfmejQe8_oGcQW-xVjhefLEqDbAi83_IPn-5fPi-GRyevZ1dnx0OtEFz-KEMWgqoJWpdSk0V7qq6txktBY0Z7oEQ4FXOdeFZrzJ8rKgJTXABWTa0LrOxEHy-sZv37ogNzUOkpWi5IzlJUdidkM0Tl3K3tu18tfSKSv_KZxfSuXxlS1IlmvKjOZag05TU9e6Vigzw7AVRVOgr4-baEO9hkZjtbxqd5zu3nR2JZfuSmaMpqIc0327ceDdzwFClGsbNLRYM3DDmHeap7SosvQBqKgYrSoxoof_ofcXYkMtFb7VdsZhinp0Ko_SgpUZVrpEanoPhV8DOGI4u8aifsfg3Y4BMhF-x6UaQpCz-cXD2bMfu-ybLXYFqo2r4NphHL6wC6Y3oPYuBA_mrh-MynH1bqshx9WTm9VDs1fbvbwzut018Rf0JCs_</recordid><startdate>20161110</startdate><enddate>20161110</enddate><creator>van Roest, Margijske H G</creator><creator>van der Aa, Maaike A</creator><creator>van der Geest, Lydia G M</creator><creator>de Jong, Koert P</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20161110</creationdate><title>The Impact of Socioeconomic Status, Surgical Resection and Type of Hospital on Survival in Patients with Pancreatic Cancer. 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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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27832174</pmid><doi>10.1371/journal.pone.0166449</doi><tpages>e0166449</tpages><oa>free_for_read</oa></addata></record> |
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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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