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A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer

BACKGROUND: To describe patterns of referral, consultation, and treatment of advanced pancreatic cancer patients in a population‐based health care system and to evaluate the impact of these factors on outcomes. METHODS: This is a retrospective analysis of population‐based cancer data from the provin...

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Autores principales: Abdel‐Rahman, Omar, Xu, Yuan, Tang, Patricia A., Lee‐Ying, Richard M., Cheung, Winson Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308068/
https://www.ncbi.nlm.nih.gov/pubmed/30378285
http://dx.doi.org/10.1002/cam4.1841
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author Abdel‐Rahman, Omar
Xu, Yuan
Tang, Patricia A.
Lee‐Ying, Richard M.
Cheung, Winson Y.
author_facet Abdel‐Rahman, Omar
Xu, Yuan
Tang, Patricia A.
Lee‐Ying, Richard M.
Cheung, Winson Y.
author_sort Abdel‐Rahman, Omar
collection PubMed
description BACKGROUND: To describe patterns of referral, consultation, and treatment of advanced pancreatic cancer patients in a population‐based health care system and to evaluate the impact of these factors on outcomes. METHODS: This is a retrospective analysis of population‐based cancer data from the province of Alberta, Canada. We analyzed patients diagnosed with either locally advanced or metastatic pancreatic adenocarcinoma from 2009 to 2016 and evaluated their patterns of referral to a cancer center, consultation with oncology, and treatment with active anticancer therapies. Logistic regression models were constructed to determine the factors associated with referral, late oncology assessment, and late receipt of treatment. RESULTS: We identified 1621 pancreatic cancer patients. Median age was 70 years, 50% were men, and 51% had a Charlson index of 2+. Within this cohort, only 884 (54%) patients were referred to one of the provincial cancer centers. Adjusting for confounders in logistic regression models, older age and worse comorbidity scores were associated with nonreferral (both P < 0.01). In multivariable analysis among treated patients, the following factors were associated with improved overall survival, including younger age, earlier stage, and better comorbidity scores (all P < 0.01). Neither referral to consultation times nor consultation to treatment times correlated with outcomes. Importantly, nonreferred patients were more likely to use acute care services, including longer total duration of hospitalizations and more frequent visits with physician specialists. CONCLUSION: A significant proportion of patients with advanced pancreatic cancer were never referred to a cancer center. Nonreferred patients were more likely to utilize specific health care resources.
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spelling pubmed-63080682019-01-03 A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer Abdel‐Rahman, Omar Xu, Yuan Tang, Patricia A. Lee‐Ying, Richard M. Cheung, Winson Y. Cancer Med Cancer Prevention BACKGROUND: To describe patterns of referral, consultation, and treatment of advanced pancreatic cancer patients in a population‐based health care system and to evaluate the impact of these factors on outcomes. METHODS: This is a retrospective analysis of population‐based cancer data from the province of Alberta, Canada. We analyzed patients diagnosed with either locally advanced or metastatic pancreatic adenocarcinoma from 2009 to 2016 and evaluated their patterns of referral to a cancer center, consultation with oncology, and treatment with active anticancer therapies. Logistic regression models were constructed to determine the factors associated with referral, late oncology assessment, and late receipt of treatment. RESULTS: We identified 1621 pancreatic cancer patients. Median age was 70 years, 50% were men, and 51% had a Charlson index of 2+. Within this cohort, only 884 (54%) patients were referred to one of the provincial cancer centers. Adjusting for confounders in logistic regression models, older age and worse comorbidity scores were associated with nonreferral (both P < 0.01). In multivariable analysis among treated patients, the following factors were associated with improved overall survival, including younger age, earlier stage, and better comorbidity scores (all P < 0.01). Neither referral to consultation times nor consultation to treatment times correlated with outcomes. Importantly, nonreferred patients were more likely to use acute care services, including longer total duration of hospitalizations and more frequent visits with physician specialists. CONCLUSION: A significant proportion of patients with advanced pancreatic cancer were never referred to a cancer center. Nonreferred patients were more likely to utilize specific health care resources. John Wiley and Sons Inc. 2018-10-30 /pmc/articles/PMC6308068/ /pubmed/30378285 http://dx.doi.org/10.1002/cam4.1841 Text en © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Abdel‐Rahman, Omar
Xu, Yuan
Tang, Patricia A.
Lee‐Ying, Richard M.
Cheung, Winson Y.
A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title_full A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title_fullStr A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title_full_unstemmed A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title_short A real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
title_sort real‐world, population‐based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308068/
https://www.ncbi.nlm.nih.gov/pubmed/30378285
http://dx.doi.org/10.1002/cam4.1841
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