Publication Date
1-1-2024
Journal
Pancreas
DOI
10.1097/MPA.0000000000002272
PMID
37967826
PMCID
PMC10883640
PubMedCentral® Posted Date
1-1-2025
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Humans, Adenocarcinoma, Black or African American, Healthcare Disparities, Pancreatic Neoplasms, United States, Veterans, White, Veterans Health Services, Pancreatic cancer, race, health disparities, cancer treatment, survival, epidemiology
Abstract
OBJECTIVES: Among patients with pancreatic cancer, studies show racial disparities at multiple steps of the cancer care pathway. Access to healthcare is a frequently cited cause of these disparities. It remains unclear if racial disparities exist in an integrated, equal access public system such as the Veterans Affairs healthcare system.
METHODS: We identified all patients diagnosed with pancreatic adenocarcinoma in the national Veterans Affairs Central Cancer Registry from January 2010 to December 2018. We examined the independent association between race and 3 endpoints: stage at diagnosis, receipt of treatment, and survival while adjusting for sociodemographic factors and medical comorbidities.
RESULTS: We identified 8529 patients with pancreatic adenocarcinoma, of whom 79.5% were White and 20.5% were Black. Black patients were 19% more likely to have late-stage disease and 25% less likely to undergo surgical resection. Black patients had 13% higher mortality risk compared with White patients after adjusting for sociodemographic characteristics and medical comorbidities. This difference in mortality was no longer statistically significant after additionally adjusting for cancer stage and receipt of potentially curative treatment.
CONCLUSIONS: Equal access to healthcare might have reduced but failed to eliminate disparities. Dedicated efforts are needed to understand reasons underlying these disparities in an attempt to close these persistent gaps.
Included in
Digestive System Diseases Commons, Gastroenterology Commons, Hepatology Commons, Medical Sciences Commons, Oncology Commons, Race and Ethnicity Commons