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Invited Commentary
April 2016

Outcome Disparities in Pancreatic Cancer: Need for Improved Regionalization of Care

Author Affiliations
  • 1Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
JAMA Surg. 2016;151(4):345-346. doi:10.1001/jamasurg.2015.4221

The study published in this issue of JAMA Surgery by Shapiro et al1 sought to understand differences in outcomes observed in early-stage pancreatic cancer. The authors used a population-level cancer registry (Surveillance, Epidemiology, and End Results Program) and included patients with localized disease only, for whom surgery is the gold standard. Among the most striking findings was the low and stagnant rate of surgical treatment over time (resection, 45.4%); sociodemographic characteristics (race, ethnicity, marital status, geographic location, and insurance status) were found to independently predict resection. A noteworthy finding was that the effect of these factors on outcomes (cancer-specific survival) disappeared for patients having resection; however, significant variation in cancer-specific survival was observed by geographic location, even after adjusting for other relevant tumor-based characteristics.

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