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.
方法:机构审查委员会批准的对我们的机构癌症注册和PMDC数据库的回顾性审查确定了2014年至2022年之间诊断/治疗胰腺导管腺癌的患者。卡方检验用于分类变量,连续变量使用带有Bonferroni校正的单向方差分析。统计学显著性设定为p<0.05。
结果:总共286名患者符合纳入标准。89名患者(31.1%)是少数族裔(URM)。EP期间出现的57个(64.0%)URM与100个(50.8%)非URM(p=0.037)。在PMDC中审查了41个(46.1%)URM,而非URM为71个(36.0%)(p=0.10)。队列之间的临床和病理阶段没有差异(p=0.28)。URM平均需要22天的时间才能接受治疗(66.5天vs.44.8天,p=0.003)在EP队列中,在OP队列中延长18天(58.0天vs.40.5天,p<0.001)与非URM相比。EP队列中的胰腺多学科诊所招募消除了队列之间治疗时间的差异(48.3天vs.37.0天;p=0.151)。
结果:与非URM对应者相比,代表性不足的少数民族更有可能通过EP诊断,并显示延迟治疗时间。我们的PMDC缓解了一些观察到的差异。未来的研究需要阐明导致这些发现的具体因素,并确定解决方案。