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. 2012 Apr;138(4):715-22.
doi: 10.1007/s00432-012-1156-8. Epub 2012 Jan 15.

Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis

Vinamrata Singal  1 , Ashwani K Singal, Yong-Fang Kuo
Affiliations

Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis

Vinamrata Singal et al. J Cancer Res Clin Oncol. 2012 Apr.

Abstract

Purpose: Pancreatic adenocarcinoma is the fourth leading cause of cancer-related deaths in both men and women. Mortality from pancreatic cancer is higher amongst blacks compared to other races. We performed this analysis with the aim of examining racial disparity for receipt pancreatic cancer treatment and its association with survival.

Methods: Using the surveillance, epidemiology, and end results (SEER) database from 1988 to 2008, cases with locoregional pancreatic cancer were analysed. Kaplan-Meier survival curves were assessed to assess the survival amongst various races. Cox proportional hazard model was built to assess the impact of receipt of treatment on the racial disparity in survival.

Results: Of 16,282 cases with locoregional pancreatic cancer, 1,806 (11%) occurred in blacks. Median survival was 8-9 months with poorest survival in blacks. Blacks and Hispanics received radiation treatment less often compared to other races. On Cox regression logistic regression analysis, blacks had 20% poorer survival compared to whites. Treatment for pancreatic cancer explained only one-fourth of this poorer survival.

Conclusion: Blacks have worst survival from locoregional pancreatic cancer. Receiving treatment for pancreatic cancer only explains 25% of the poorer survival amongst blacks, suggesting role of other factors. Studies are suggested to (a) identify barriers in receipt of treatment for pancreatic cancer amongst blacks and (b) to assess role of genetic and other factors to examine racial differences in survival.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curves for different races. Results show that the median survival is 7–9 months with worst survival amongst blacks as compared to other races (log rank P value: 0.0023)
Fig. 2
Fig. 2
a Rates of pancreatic resection amongst different races during different time periods. Results show that the resection rates have increased over time in all the races. Rates are similar in blacks and whites. b Rates of receiving radiation treatment for pancreatic resection amongst various races during different time periods. Results show that the radiation rates have remained more or less stable over time in all the races. Rates are lower in blacks and Hispanics as compared to whites for the most part
See this image and copyright information in PMC

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