Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting

Introduction Our analysis was designed to characterize the demographics and disparities between the diagnosis of pancreas cancer during emergency presentation (EP) and the outpatient setting (OP) and to see the impact of our institutions pancreatic multidisciplinary clinic (PMDC) on these disparitie...

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Veröffentlicht in:Annals of surgical oncology 2024-08, Vol.31 (8), p.4986-4996
Hauptverfasser: Fallon, John, Standring, Oliver, Vithlani, Nandan, Demyan, Lyudmyla, Shah, Manav, Gazzara, Emma, Hartman, Sarah, Pasha, Shamsher, King, Daniel A., Herman, Joseph M., Weiss, Matthew J., DePeralta, Danielle, Deutsch, Gary
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container_end_page 4996
container_issue 8
container_start_page 4986
container_title Annals of surgical oncology
container_volume 31
creator Fallon, John
Standring, Oliver
Vithlani, Nandan
Demyan, Lyudmyla
Shah, Manav
Gazzara, Emma
Hartman, Sarah
Pasha, Shamsher
King, Daniel A.
Herman, Joseph M.
Weiss, Matthew J.
DePeralta, Danielle
Deutsch, Gary
description Introduction Our analysis was designed to characterize the demographics and disparities between the diagnosis of pancreas cancer during emergency presentation (EP) and the outpatient setting (OP) and to see the impact of our institutions pancreatic multidisciplinary clinic (PMDC) on these disparities. Methods Institutional review board-approved retrospective review of our institutional cancer registry and PMDC databases identified patients diagnosed/treated for pancreatic ductal adenocarcinoma between 2014 and 2022. Chi-square tests were used for categorical variables, and one-way ANOVA with a Bonferroni correction was used for continuous variables. Statistical significance was set at p < 0.05. Results A total of 286 patients met inclusion criteria. Eighty-nine patients (31.1%) were underrepresented minorities (URM). Fifty-seven (64.0%) URMs presented during an EP versus 100 (50.8%) non-URMs ( p = 0.037). Forty-one (46.1%) URMs were reviewed at PMDC versus 71 (36.0%) non-URMs ( p = 0.10). No differences in clinical and pathologic stage between the cohorts ( p = 0.28) were present. URMs took 22 days longer on average to receive treatment (66.5 days vs. 44.8 days, p = 0.003) in the EP cohort and 18 days longer in OP cohort (58.0 days vs. 40.5 days, p < 0.001) compared with non-URMs. Pancreatic Multidisciplinary Clinic enrollment in EP cohort eliminated the difference in time to treatment between cohorts (48.3 days vs. 37.0 days; p = 0.151). Results Underrepresented minorities were more likely to be diagnosed via EP and showed delayed times to treatment compared with non-URM counterparts. Our PMDC alleviated some of these observed disparities. Future studies are required to elucidate the specific factors that resulted in these findings and to identify solutions.
doi_str_mv 10.1245/s10434-024-15352-3
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Methods Institutional review board-approved retrospective review of our institutional cancer registry and PMDC databases identified patients diagnosed/treated for pancreatic ductal adenocarcinoma between 2014 and 2022. Chi-square tests were used for categorical variables, and one-way ANOVA with a Bonferroni correction was used for continuous variables. Statistical significance was set at p &lt; 0.05. Results A total of 286 patients met inclusion criteria. Eighty-nine patients (31.1%) were underrepresented minorities (URM). Fifty-seven (64.0%) URMs presented during an EP versus 100 (50.8%) non-URMs ( p = 0.037). Forty-one (46.1%) URMs were reviewed at PMDC versus 71 (36.0%) non-URMs ( p = 0.10). No differences in clinical and pathologic stage between the cohorts ( p = 0.28) were present. URMs took 22 days longer on average to receive treatment (66.5 days vs. 44.8 days, p = 0.003) in the EP cohort and 18 days longer in OP cohort (58.0 days vs. 40.5 days, p &lt; 0.001) compared with non-URMs. Pancreatic Multidisciplinary Clinic enrollment in EP cohort eliminated the difference in time to treatment between cohorts (48.3 days vs. 37.0 days; p = 0.151). Results Underrepresented minorities were more likely to be diagnosed via EP and showed delayed times to treatment compared with non-URM counterparts. Our PMDC alleviated some of these observed disparities. Future studies are required to elucidate the specific factors that resulted in these findings and to identify solutions.</description><identifier>ISSN: 1068-9265</identifier><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-024-15352-3</identifier><identifier>PMID: 38789617</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adenocarcinoma ; Cancer ; Cancer therapies ; Diagnosis ; Medicine ; Medicine &amp; Public Health ; Oncology ; Pancreatic cancer ; Pancreatic Tumors ; Patients ; Statistical analysis ; Surgery ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2024-08, Vol.31 (8), p.4986-4996</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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subjects Adenocarcinoma
Cancer
Cancer therapies
Diagnosis
Medicine
Medicine & Public Health
Oncology
Pancreatic cancer
Pancreatic Tumors
Patients
Statistical analysis
Surgery
Surgical Oncology
title Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting
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