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Zip codes Drive Overall survival for patients diagnosed with pancreatic cancer

2021; Elsevier BV; Volume: 23; Linguagem: Inglês

10.1016/j.hpb.2020.11.624

1477-2574

Cataldo Doria, S. Ranieri Dolan, Patrick G. De Deyne, K. Yatcilla, Jaeyoon Chung, Ethan J. Schwartz,

Cancer Genomics and Diagnostics

Introduction: The purpose of this study was to determine if a patient's zip code is affecting patient overall survival (OS) when diagnosed with pancreatic cancer. Our hypothesis was that socio-economic status (SES) is associated with this outcome. Methods: We interrogated a convenience sample from our cancer center registry and obtained 479 subjects diagnosed with pancreatic cancer between 2010-2018. We selected subjects (328) by zip code, representing the plurality of the cases in our catchment area. Outcome variables were overall survival and socio-economic status; predictor variables were recurrence, insurance, type of treatment, gender, cancer stage, age, and gender. We converted zip code to municipality and culled data using Adjusted Gross Income (AGI, FY 2017) We then created groups using a cutoff at filings of >$100,000 of AGI; Low SES = municipalities where ≤5% of the filings were over $100,000, Mid SES = municipalities where between 5%-40% of the filings were over $100,000, High SES = municipalities where ≥40% of returns were over $100,000. Comparative statistical analysis was performed using Chi-square for nominal and ordinal variables, a two-way ANOVA test was used for continuous variables, p- value was set at 0.05. Results: We found a statistical significant difference in OS in patients with low SES, Table 1. Conclusion: We believe that our findings are multifactorial. Access to care, optimal nutritional status, overall fitness, co-morbidities could play a major role and confound the results. Our study suggests low SES has a negative impact on overall pancreatic cancer survival and deserves additional study.