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. 2024 Aug;31(8):4986-4996.
doi: 10.1245/s10434-024-15352-3. Epub 2024 May 24.

Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting

John Fallon  1 , Oliver Standring  2 , Nandan Vithlani  3 , Lyudmyla Demyan  2 , Manav Shah  3 , Emma Gazzara  3   2 , Sarah Hartman  3   2 , Shamsher Pasha  4 , Daniel A King  5 , Joseph M Herman  6 , Matthew J Weiss  3   4 , Danielle DePeralta  3   4 , Gary Deutsch  3   4
Affiliations

Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting

John Fallon et al. Ann Surg Oncol. 2024 Aug.

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: 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.

Keywords: Diagnosis location; Disparities; Multidisciplinary clinic; Pancreas cancer; Treatment time.

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Conflict of interest statement

There are no conflicts of interest or sources of funding associated with this manuscript.

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