It's more than just cancer biology: Health disparities in patients with pancreatic neuroendocrine tumors

Abstract

Background and Objectives Pancreatic neuroendocrine tumors (PNETs) represent a rare form of pancreatic cancer. Racial/ethnic disparities have been documented in pancreatic ductal adenocarcinoma, but health disparities have not been well described in patients with PNETs. Methods A retrospective review of patients with PNETs in the National Cancer Database was performed for 2004–2014. Approximately 16 605 patients with PNETs and available vital status were identified. Survival was compared by race/ethnicity and socioeconomic status using Kaplan–Meier methods and Cox regression. Results There were no significant differences in survival between Non‐Hispanic, White; Hispanic, White; or Non‐Hispanic, Black patients on univariate analysis. Kaplan–Meier analysis showed that patients from communities with lower median household income and education level had worse survival (p < 0.001). Patients age less than 65 without insurance, similarly, had worse survival (p < 0.001). Multivariable modeling found no association between race/ethnicity and risk of mortality (p = 0.37). Lower median household income and lower education level were associated with increased mortality (p < 0.001). Conclusions Unlike most other malignancies, race/ethnicity is not associated with survival differences in patients with PNETs. Patients with lower socioeconomic status had worse survival. The presence of identifiable health disparities in patients with PNETs represents a target for intervention and opportunity to improve survival in patients with this malignancy.

Pancreatic Cancer Health Disparity: Pharmacologic Anthropology

“…Geographic disparities play a role in PCa outcomes. Rural and underserved areas often have limited healthcare infrastructure, including oncology centers and specialized medical professionals [52,53]. Limited access to healthcare services, including cancer screening and treatment facilities, can result in delayed diagnosis, reduced treatment options, and poorer survival rates for individuals residing in these areas [54].…”

“…Addressing socioeconomic factors in PCa health disparities requires a multi-faceted approach that includes improving access to healthcare, enhancing health education and awareness, supporting the socioeconomically disadvantaged, strengthening occupational Geographic disparities play a role in PCa outcomes. Rural and underserved areas often have limited healthcare infrastructure, including oncology centers and specialized medical professionals [52,53]. Limited access to healthcare services, including cancer screening and treatment facilities, can result in delayed diagnosis, reduced treatment options, and poorer survival rates for individuals residing in these areas [54].…”

“…Disparities in health insurance coverage contribute to inequitable access to PCa care. Efforts should be directed towards expanding healthcare coverage and reducing insurance barriers, particularly for low-income individuals and underserved populations [44,53,76]. This includes promoting Medicaid expansion, implementing health insurance programs for uninsured individuals, and advocating for policies that ensure comprehensive coverage for PCa-related services [76,167].…”