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Healthcare vulnerability disparities in pancreatic cancer treatment and mortality using the Korean National Sample Cohort: a retrospective cohort study

 Sung Hoon Jeong  ;  Hyeon Ji Lee  ;  Choa Yun  ;  Il Yun  ;  Yun Hwa Jung  ;  Soo Young Kim  ;  Hee Seung Lee  ;  Sung-In Jang 
 BMC CANCER, Vol.22(1) : 925, 2022-08 
Journal Title
Issue Date
Cohort Studies ; Healthcare Disparities ; Humans ; Pancreatic Neoplasms* ; Republic of Korea ; Retrospective Studies
Epidemiology ; Healthcare vulnerability ; Pancreatic cancer ; Pancreatic cancer treatment ; Regional disparities
Background: The gap in treatment and health outcomes after diagnosis of pancreatic cancer is a major public health concern. We aimed to investigate the differences in the health outcomes and treatment of pancreatic cancer patients in healthcare vulnerable and non-vulnerable areas.

Methods: This retrospective cohort study evaluated data from the Korea National Health Insurance Corporation-National Sample Cohort from 2002 to 2019. The position value for relative comparison index was used to define healthcare vulnerable areas. Cox proportional hazard regression was used to estimate the risk of mortality in pancreatic cancer patients according to healthcare vulnerable areas, and multiple logistic regression was used to estimate the difference in treatment.

Results: Among 1,975 patients, 279 (14.1%) and 1,696 (85.9%) lived in the healthcare vulnerable and non-vulnerable areas, respectively. Compared with the non-vulnerable area, pancreatic cancer patients in the vulnerable area had a higher risk of death at 3 months (hazard ratio [HR]: 1.33, 95% confidence interval [CI] = 1.06-1.67) and 6 months (HR: 1.23, 95% CI = 1.03-1.48). In addition, patients with pancreatic cancer in the vulnerable area were less likely to receive treatment than patients in the non-vulnerable area (odds ratio [OR]: 0.70, 95% CI = 0.52-0.94). This trend was further emphasized for chemotherapy (OR: 0.68, 95% CI = 0.48-0.95).

Conclusion: Patients with pancreatic cancer belonging to medically disadvantaged areas receive less treatment and have a higher risk of death. This may be a result of the late diagnosis of pancreatic cancer among these patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
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