Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2024 May 24

PMID 38789617

Authors

John Fallon

Oliver Standring

Nandan Vithlani

Lyudmyla Demyan

Manav Shah

Emma Gazzara

Sarah Hartman

Shamsher Pasha

Daniel A King

Joseph M Herman

Matthew J Weiss

Danielle Deperalta

Gary Deutsch

Affiliations

Soon will be listed here.

Abstract

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: 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.

References

Salom F, Prat F . Current role of endoscopic ultrasound in the diagnosis and management of pancreatic cancer. World J Gastrointest Endosc. 2022; 14(1):35-48. PMC: 8788172. DOI: 10.4253/wjge.v14.i1.35. View

Orth M, Metzger P, Gerum S, Mayerle J, Schneider G, Belka C . Pancreatic ductal adenocarcinoma: biological hallmarks, current status, and future perspectives of combined modality treatment approaches. Radiat Oncol. 2019; 14(1):141. PMC: 6688256. DOI: 10.1186/s13014-019-1345-6. View

Khorana A, Tullio K, Elson P, Pennell N, Grobmyer S, Kalady M . Time to initial cancer treatment in the United States and association with survival over time: An observational study. PLoS One. 2019; 14(3):e0213209. PMC: 6396925. DOI: 10.1371/journal.pone.0213209. View

Luchini C, Capelli P, Scarpa A . Pancreatic Ductal Adenocarcinoma and Its Variants. Surg Pathol Clin. 2016; 9(4):547-560. DOI: 10.1016/j.path.2016.05.003. View

Gamboa A, Rupji M, Switchenko J, Lee R, Turgeon M, Meyer B . Optimal timing and treatment strategy for pancreatic cancer. J Surg Oncol. 2020; 122(3):457-468. PMC: 7396281. DOI: 10.1002/jso.25976. View

Riner A, Underwood P, Yang K, Herremans K, Cameron M, Chamala S . Disparities in Pancreatic Ductal Adenocarcinoma-The Significance of Hispanic Ethnicity, Subgroup Analysis, and Treatment Facility on Clinical Outcomes. Cancer Med. 2020; 9(12):4069-4082. PMC: 7300394. DOI: 10.1002/cam4.3042. View

Nipp R, Tramontano A, Kong C, Pandharipande P, Dowling E, Schrag D . Disparities in cancer outcomes across age, sex, and race/ethnicity among patients with pancreatic cancer. Cancer Med. 2018; 7(2):525-535. PMC: 5806100. DOI: 10.1002/cam4.1277. View

Lutfi W, Zenati M, Zureikat A, Zeh H, Hogg M . Health Disparities Impact Expected Treatment of Pancreatic Ductal Adenocarcinoma Nationally. Ann Surg Oncol. 2018; 25(7):1860-1867. DOI: 10.1245/s10434-018-6487-5. View

Moaven O, Richman J, Reddy S, Wang T, Heslin M, Contreras C . Healthcare disparities in outcomes of patients with resectable pancreatic cancer. Am J Surg. 2018; 217(4):725-731. DOI: 10.1016/j.amjsurg.2018.12.007. View

10.

Weithorn D, Arientyl V, Solsky I, Umadat G, Levine R, Rapkin B . Diagnosis Setting and Colorectal Cancer Outcomes: The Impact of Cancer Diagnosis in the Emergency Department. J Surg Res. 2020; 255:164-171. PMC: 8029600. DOI: 10.1016/j.jss.2020.05.005. View

11.

Delamare Fauvel A, Bischof J, Reinbolt R, Weihing V, Boyer E, Caterino J . Diagnosis of cancer in the Emergency Department: A scoping review. Cancer Med. 2023; 12(7):8710-8728. PMC: 10134283. DOI: 10.1002/cam4.5600. View

12.

Solsky I, Rapkin B, Wong K, Friedmann P, Muscarella P, In H . Gastric cancer diagnosis after presentation to the ED: The independent association of presenting location and outcomes. Am J Surg. 2017; 216(2):286-292. DOI: 10.1016/j.amjsurg.2017.10.030. View

13.

Newsom-Davis T . The route to diagnosis: emergency presentation of lung cancer. Lung Cancer Manag. 2019; 6(2):67-73. PMC: 6310353. DOI: 10.2217/lmt-2017-0004. View

14.

Gobbi P, Bergonzi M, Comelli M, Villano L, Pozzoli D, Vanoli A . The prognostic role of time to diagnosis and presenting symptoms in patients with pancreatic cancer. Cancer Epidemiol. 2013; 37(2):186-90. DOI: 10.1016/j.canep.2012.12.002. View

15.

Hanna T, King W, Thibodeau S, Jalink M, Paulin G, Harvey-Jones E . Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020; 371:m4087. PMC: 7610021. DOI: 10.1136/bmj.m4087. View

16.

Buac N, Khusid J, Sturgis M, Gupta M, Lundon D, Chow A . Disparities in patient and system factors explain racial/ethnic disparities in delayed time to treatment in muscle invasive bladder cancer. Urol Oncol. 2022; 40(7):343.e15-343.e20. DOI: 10.1016/j.urolonc.2022.02.008. View

17.

Lawson M, Bissell M, Miglioretti D, Eavey J, Chapman C, Mandelblatt J . Multilevel Factors Associated With Time to Biopsy After Abnormal Screening Mammography Results by Race and Ethnicity. JAMA Oncol. 2022; 8(8):1115-1126. PMC: 9227677. DOI: 10.1001/jamaoncol.2022.1990. View

18.

George P, Chandwani S, Gabel M, Ambrosone C, Rhoads G, Bandera E . Diagnosis and surgical delays in African American and white women with early-stage breast cancer. J Womens Health (Larchmt). 2015; 24(3):209-17. PMC: 4442576. DOI: 10.1089/jwh.2014.4773. View

19.

Reeder-Hayes K, Mayer S, Olshan A, Wheeler S, Carey L, Tse C . Race and delays in breast cancer treatment across the care continuum in the Carolina Breast Cancer Study. Cancer. 2019; 125(22):3985-3992. PMC: 6819218. DOI: 10.1002/cncr.32378. View

20.

Schermerhorn M, Grunvald M, ODonoghue C, Rao R, Becerra A . Factors Mediating Racial/Ethnic Disparities in Delayed Treatment of Breast Cancer. Ann Surg Oncol. 2022; 29(12):7652-7658. PMC: 9244454. DOI: 10.1245/s10434-022-12001-5. View