PDF(Pubmed)
Abstract：
BACKGROUND: 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.
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.
摘要：
背景：我们的分析旨在描述在急诊就诊（EP）和门诊（OP）期间胰腺癌诊断之间的人口统计学和差异，并了解我们机构胰腺多学科诊所（PMDC）对这些差异的影响。
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。
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。
