Access to pancreatic cancer surgery linked to demographics

Last Updated: 2015-11-19

By Andrew M. Seaman

(Reuters Health) - Social and economic factors may influence patients' odds of undergoing surgery for early-stage pancreas cancer, and eliminating these gaps could improve outcomes, U.S. researchers say.

Race, marital status, insurance coverage and region were linked to stage at diagnosis and to the odds of surgery.

People who got surgery tended to live much longer than those who didn't.

"It likely indicates that efforts to improve outcomes for pancreas cancer are best aimed at eliminating disparities in access and utilization of resection for early-stage pancreas cancer," said senior author Dr. Jason Gold, of Harvard Medical School and the VA Boston Healthcare System.

For the new study, reported online November 19 in JAMA Surgery, the researchers looked at data from 17,530 people diagnosed with pancreas cancer in the U.S. between 2004 and 2011.

About 45 percent underwent resection, and that rate did not change throughout the study period. But people who were white, non-Hispanic, married, insured and living in the Northeast had higher odds of undergoing surgery.

Those who had surgery lived an average of 21 months after diagnosis, compared to an average of six months for those who didn't.

While many factors were tied to the odds of undergoing surgery, among those who did have resections, only geographic location was independently linked to survival afterward.

Patients who had resections and lived in Northeast, Pacific West or the Midwest tended to live longer than those who lived in the Southeast.

While the study can't determine why location is tied to better survival after surgery, the researchers say there are a few possible explanations. One is that hospitals in the Southeast may have lower case volumes and that difference may influence the surgery outcomes.

The study is also limited by a lack of information on factors that may determine whether the cancer is operable, write Drs. Daniel Anaya and Makenge Malafa of H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, in a commentary accompanying the study.

But, Anaya and Malafa add, the findings point to what can be done to improve survival for all pancreatic cancer patients.

Gold also told Reuters Health that future research should focus on improving access to surgery for all patients with early-stage pancreas cancer.

SOURCE: http://bit.ly/1I0aCI9 and http://bit.ly/1I0aDff

JAMA Surgery 2015.