Regional and socio-economic variation in survival after a pancreatic cancer diagnosis in Denmark.

INTRODUCTION

Pancreatic cancer is among the most lethal malignancies with a five-year survival of about 5%, and the only curative treatment is surgical resection. Denmark consists of five governmental regions and has four surgical centres. Our aim was to explore the regional and socio-economic differences in overall survival following a pancreatic cancer diagnosis in Denmark.

METHODS

We included a total of 5,244 pancreatic cancer patients (WHO International Classification of Diseases, tenth version C25) registered in the Danish Pancreatic Cancer Database during 2012-2017. The data sources used were the Danish Civil Registration System, the Danish National Patient Registry and the Danish national registers on education and income at Statistics Denmark. Cox regression analysis was used to examine all-cause mortality of pancreatic cancer patients by region of residence and socio-economic status.

RESULTS

Compared to The Capital Region, there was an excess mortality in the Central Denmark Region and the North Denmark Region in both men and women, whereas no increased mortality was observed in the Region of Southern Denmark or in Region Zealand. Estimates were adjusted for age, year of diagnosis and comorbidity. Adjustment for surgical resection greatly attenuated the variation in survival between the regions.

CONCLUSIONS

We found significant differences in overall survival across the five Danish regions following a diagnosis of pancreatic cancer. The regional variation in survival was largely attributable to differences in the propensity to use surgical resection.

FUNDING

none.

TRIAL REGISTRATION

not relevant.