Abstract

Little is known about the features and outcomes of Brazilian patients with pancreatic cancer. We sought to describe the socio-economic characteristics, patterns of health care access, and survival of patients diagnosed with malignant pancreatic tumors from 2000 to 2014 in São Paulo, Brazil. We included patients with malignant exocrine and non-classified pancreatic tumors according to the International Classifications of Disease (ICD)-O-2 and -O-3, diagnosed from 2000 to 2014, who were registered in the FOSP database. Prognostic factors for overall survival (OS) in the subgroup of patients with ductal or non-specified (adeno)carcinoma were evaluated using Cox proportional hazard model. The study population consists of 6855 patients. Median time from the first visit to diagnosis and treatment were 13 (Interquartile range [IQR] 4–30) and 24 (IQR 8–55) days, respectively. Both intervals were longer for patients treated in the public setting. Median OS was 4.9 months (95% confidence interval [95% CI] 4.7–5.2). Increasing age, male gender, lower educational level, treatment in the public setting, absence of treatment, advanced stage, and treatment from 2000 to 2004 were associated with inferior OS. From 2000–2004 to 2010–2014, no improvement in OS was seen for patients treated in the public setting. Survival of patients with malignant pancreatic tumors remains dismal. Socioeconomical variables, especially health care funding, are major determinants of survival. Further work is necessary to decrease inequalities in access to medical care for patients with pancreatic cancer in Brazil.

Details

Title
Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
Author
de Jesus Victor Hugo Fonseca 1 ; da Costa Wilson Luiz Jr 2 ; Claro Laura Carolina Lopez 3 ; Coimbra Felipe José Fernandez 4 ; Dettino Aldo Lourenço Abbade 1 ; Riechelmann, Rachel P 1 ; Curado, Maria Paula 5 

 A.C. Camargo Cancer Center, Medical Oncology Department, São Paulo, Brazil (GRID:grid.413320.7) (ISNI:0000 0004 0437 1183) 
 A.C. Camargo Cancer Center, Abdominal Surgery Department, São Paulo, Brazil (GRID:grid.413320.7) (ISNI:0000 0004 0437 1183); Baylor College of Medicine, Department of Medicine/Epidemiology and Population Sciences, Houston, USA (GRID:grid.39382.33) (ISNI:0000 0001 2160 926X) 
 A.C. Camargo Cancer Center, Pathology Department, São Paulo, Brazil (GRID:grid.413320.7) (ISNI:0000 0004 0437 1183) 
 A.C. Camargo Cancer Center, Abdominal Surgery Department, São Paulo, Brazil (GRID:grid.413320.7) (ISNI:0000 0004 0437 1183) 
 A.C. Camargo Cancer Center, Department of Epidemiology and Statistics-International Research Center (CIPE), São Paulo, Brazil (GRID:grid.413320.7) (ISNI:0000 0004 0437 1183) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2502556098
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.