Race Does Not Impact Pancreatic Cancer Treatment and Survival in an Equal Access Federal Health Care System
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Black patients with pancreatic adenocarcinoma (PDAC) have been reported to undergo surgical resection less frequently and to have a shorter overall survival duration than white patients. We sought to determine whether disparities in clinical management and overall survival exist between black and white patients with PDAC treated in an equal access health care system.
Using the Department of Defense (DoD) tumor registry database from 1993 to 2007, patient, tumor, and treatment factors were analyzed to compare rates of therapy and survival between black and white patients.
Of 1,008 patients with PDAC, 157 were black (15 %). Thirty-six percent of black and 37 % of white patients presented with locoregional disease (p = 0.85). Among those with locoregional cancers, the odds of black patients having received surgical resection (odds ratio [OR] 1.06, 95 % confidence interval [CI] 0.60–1.89), chemotherapy (OR 0.92, 95 % CI 0.49–1.73) and radiotherapy (OR 1.14, 95 % CI 0.61–2.10) were not different from those of whites. Among those with distant disease, the odds of having received palliative chemotherapy were also similar (OR 0.91, 95 % CI 0.55–1.51). Black and white patients with PDAC had a similar median overall survival. In a multivariate analysis, as compared to whites, black race was not associated with shorter overall survival.
We observed no disparities in either management or survival between white and black patients with PDAC treated in the DoD’s equal access health care system. These data suggest that improving the access of minorities with PDAC to health care may reduce disparities in their oncologic outcomes.
KeywordsPancreatic Cancer Racial Disparity Black Patient White Patient Distant Disease
- 1.Agency for Healthcare Research and Quality. 2011 national healthcare quality and disparities reports. http://www.ahrq.gov/qual/qrdr11.htm. Accessed Jan 31 2013.
- 11.Military medical care: questions and answers. February 28, 2013. http://www.fas.org/sgp/crs/misc/RL33537.pdf. Accessed May 9, 2013.
- 12.Employer Health Benefits Survey 2012. http://kff.org/health-costs/report/employer-health-benefits-2012-annual-survey/. Accessed May 10, 2013.
- 14.North American Association of Central Cancer Registries Inc. 2013 implementation guidelines and recommendations. http://www.naaccr.org/LinkClick.aspx?fileticket=WlmSkHUgKrI%3D&tabid=126&mid=466. Accessed Jan 31, 2013.
- 18.McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Differences in control of cardiovascular disease and diabetes by race, ethnicity, and education: U.S. trends from 1999 to 2006 and effects of medicare coverage. Ann Intern Med. 2009;150:505–15.Google Scholar