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Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review

Background: The incidence of pancreatic cancer is growing and the survival rate remains one of the worst in oncology. Surgical resection is currently a crucial curative option for pancreatic adenocarcinoma (PA). Socioeconomic factors could influence access to surgery. This article reviews the litera...

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Autores principales: Thobie, Alexandre, Mulliri, Andrea, Bouvier, Véronique, Launoy, Guy, Alves, Arnaud, Dejardin, Olivier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990568/
https://www.ncbi.nlm.nih.gov/pubmed/33778318
http://dx.doi.org/10.1089/heq.2019.0099
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author Thobie, Alexandre
Mulliri, Andrea
Bouvier, Véronique
Launoy, Guy
Alves, Arnaud
Dejardin, Olivier
author_facet Thobie, Alexandre
Mulliri, Andrea
Bouvier, Véronique
Launoy, Guy
Alves, Arnaud
Dejardin, Olivier
author_sort Thobie, Alexandre
collection PubMed
description Background: The incidence of pancreatic cancer is growing and the survival rate remains one of the worst in oncology. Surgical resection is currently a crucial curative option for pancreatic adenocarcinoma (PA). Socioeconomic factors could influence access to surgery. This article reviews the literature on the impact of socioeconomic status (SES) on access to curative surgery among patients with PA. Methods: The EMBASE, MEDLINE, Web of Science, and Scopus databases were searched by three investigators to generate 16 studies for review. Results: Patients with the lowest SES are less likely to undergo surgery than high SES. Low income, low levels of education, not being insured, and living in deprived and rural areas have all been associated with decreased rates of surgical resection. Given the type of health care system and geographic disparities, results in North American populations are difficult to transpose to European countries. However, a similar trend is observed in difficulty for the poorest patients in accessing resection. Low SES seems to be less likely to be offered surgery and more likely to refuse it. Conclusions: Inequalities in insurance coverage and living in poor/lower educational level areas are all demonstrated factors of a lower likelihood of resection populations. It is important to assess the causal effect of socioeconomic deprivation to improve understanding of this disease and improve access to care.
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spelling pubmed-79905682021-03-25 Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review Thobie, Alexandre Mulliri, Andrea Bouvier, Véronique Launoy, Guy Alves, Arnaud Dejardin, Olivier Health Equity Narrative Review Background: The incidence of pancreatic cancer is growing and the survival rate remains one of the worst in oncology. Surgical resection is currently a crucial curative option for pancreatic adenocarcinoma (PA). Socioeconomic factors could influence access to surgery. This article reviews the literature on the impact of socioeconomic status (SES) on access to curative surgery among patients with PA. Methods: The EMBASE, MEDLINE, Web of Science, and Scopus databases were searched by three investigators to generate 16 studies for review. Results: Patients with the lowest SES are less likely to undergo surgery than high SES. Low income, low levels of education, not being insured, and living in deprived and rural areas have all been associated with decreased rates of surgical resection. Given the type of health care system and geographic disparities, results in North American populations are difficult to transpose to European countries. However, a similar trend is observed in difficulty for the poorest patients in accessing resection. Low SES seems to be less likely to be offered surgery and more likely to refuse it. Conclusions: Inequalities in insurance coverage and living in poor/lower educational level areas are all demonstrated factors of a lower likelihood of resection populations. It is important to assess the causal effect of socioeconomic deprivation to improve understanding of this disease and improve access to care. Mary Ann Liebert, Inc., publishers 2021-03-22 /pmc/articles/PMC7990568/ /pubmed/33778318 http://dx.doi.org/10.1089/heq.2019.0099 Text en © Alexandre Thobie et al., 2021; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Narrative Review
Thobie, Alexandre
Mulliri, Andrea
Bouvier, Véronique
Launoy, Guy
Alves, Arnaud
Dejardin, Olivier
Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title_full Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title_fullStr Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title_full_unstemmed Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title_short Same Chance of Accessing Resection? Impact of Socioeconomic Status on Resection Rates Among Patients with Pancreatic Adenocarcinoma—A Systematic Review
title_sort same chance of accessing resection? impact of socioeconomic status on resection rates among patients with pancreatic adenocarcinoma—a systematic review
topic Narrative Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990568/
https://www.ncbi.nlm.nih.gov/pubmed/33778318
http://dx.doi.org/10.1089/heq.2019.0099
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