#USA #pancreatic cancer #Plymouth Meeting #NCCN #Socio-Economic Disparities

Significant Disparities in Pancreatic Cancer Treatment

Recent findings by researchers at The Ohio State University Wexner Medical Center and the James Comprehensive Cancer Center reveal alarming disparities in treatment quality and survival rates among patients with metastatic pancreatic ductal adenocarcinoma (mPDAC), particularly for those from socio-economically disadvantaged backgrounds. This study, published in the April 2025 issue of the JNCCN - Journal of the National Comprehensive Cancer Network, draws attention to the urgent need for targeted interventions to bridge these gaps...

Research Overview

The study analyzed data from 14,147 patients diagnosed with mPDAC between 2005 and 2019. It utilized the Surveillance, Epidemiology, and End Results (SEER) - Medicare database to assess how factors such as race, socioeconomic status, and overall healthcare accessibility influence treatment quality.

The researchers established quality scores based on:
1. Administration of guideline-concordant systemic therapies,
2. Access to palliative care services, and
3. Survival rates exceeding 12 months among patients.

Notably, the findings indicated that patients with higher Social Vulnerability Index (SVI) scores were 30% less likely to experience at least one of the quality indicators, identifying a critical risk factor associated with poorer outcomes. The study highlighted that individuals belonging to underrepresented racial or ethnic groups, regardless of income, also faced a 25% reduction in the likelihood of receiving quality care. Overall, a lower socioeconomic status was associated with a 34% chance of failing to meet quality guidelines, independent of racial backgrounds.

Implications for Public Policy

Diamantis Tsilimigras, MD, PhD, a lead author of the study, states that the results underscore the necessity for targeted policy interventions. He proposes that expanding Medicaid and potentially enhancing Medicare coverage for palliative care services could be pivotal in reducing these disparities. He emphasizes addressing social determinants of health, including providing financial assistance to the most vulnerable groups, and acknowledging implicit biases in treatment recommendations.

Timothy M. Pawlik, MD, PhD, MPH, MTS, MBA, underscores the importance of ensuring all patients, irrespective of their background, receive care aligned with established guidelines. The research indicated progressive improvements in quality of care and overall survival rates during the study window, though challenges remain for equitable distribution.

Addressing Long-Standing Disparities

This study adds to the growing acknowledgment of persistent treatment disparities in pancreatic cancer management. Jason S. Gold, an associate professor at Harvard Medical School who did not participate in the study, aligns with these findings, suggesting that social vulnerability, marital status, and lower income independently correlate with the quality of treatment received for mPDAC.

The study prompts compelling comments regarding the need for systematic changes in health care policies to ensure that all individuals facing pancreatic cancer have fair and equitable access to treatment options.

For more comprehensive insights and access to the full research findings titled “Quality Ratings for Patients with Metastatic Pancreatic Cancer: Trends, Racial Disparities, and Their Impact on Outcomes,” visit JNCCN.org.

In a broader context, the National Comprehensive Cancer Network (NCCN) aims to provide guidelines that enhance patient care across various demographics, advocating for accessible, effective, and equitable cancer care for everyone.