University of Hawaii Cancer Center, Honolulu, HI, USA.
John A. Burns School of Medicine, Honolulu, HI, USA.
Ethn Health. 2023 Jul;28(5):650-660. doi: 10.1080/13557858.2022.2116631. Epub 2022 Aug 28.
Racial disparities in care and outcome have been demonstrated for several cancers, but it is not clear that a similar discrepancy exists for pancreatic cancer. Furthermore, there are limited data describing the pancreatic cancer experience of Pacific Islanders. The primary objective of this study was to analyze the clinical characteristics, treatment, and outcomes of Pacific Islander patients with pancreatic cancer.
We obtained data for a consecutive sample of pancreatic adenocarcinoma patients who presented to the largest hospital in Hawaii from 1 January 2000, through 31 December 2019. Analyses were performed for the entire population and separately for patients who had their cancer resected. Overall survival was calculated by the Kaplan-Meier method. Cox proportional hazards regression models were constructed to determine the prognostic capacity of clinical and pathologic factors.
A total of 1040 patients were included in the final analysis. Pacific islanders presented at a significantly younger age compared to Whites or Asians and had the highest Medicaid rate. There were no statistically significant racial differences in stage at presentation or treatments. We did not demonstrate an association between race and survival on univariate analysis, nor after adjusting for demographic and tumor factors. Age, stage, and treatment were significantly associated with survival for both univariate and multivariate analyses.
We did not demonstrate disparate outcomes among Pacific Islanders with pancreatic cancer. This is likely due in part to the absence of a screening test and the notable poor prognosis of pancreatic adenocarcinoma. Furthermore, equity in treatment may have contributed to racial parity in survival.
多项癌症的研究表明，在医疗护理和预后方面存在种族差异，但尚不清楚胰腺癌是否存在类似差异。此外，描述太平洋岛民胰腺癌经历的数据有限。本研究的主要目的是分析太平洋岛民胰腺癌患者的临床特征、治疗和结局。
我们获取了 2000 年 1 月 1 日至 2019 年 12 月 31 日期间在夏威夷最大医院就诊的连续胰腺腺癌患者的数据。对整个人群进行了分析，并对接受癌症切除术的患者进行了单独分析。采用 Kaplan-Meier 法计算总生存率。构建 Cox 比例风险回归模型，以确定临床和病理因素的预后能力。
共有 1040 例患者纳入最终分析。与白人或亚洲人相比，太平洋岛民就诊时的年龄明显更小，并且 Medicaid 参保率最高。在就诊时的分期或治疗方面，种族间无统计学显著差异。单因素分析和多因素分析均未显示种族与生存之间存在关联。年龄、分期和治疗在单因素和多因素分析中均与生存显著相关。
我们未发现太平洋岛民胰腺癌患者的结局存在差异。这部分归因于缺乏筛查试验和胰腺腺癌显著不良预后。此外，治疗的公平性可能促成了生存方面的种族平等。
