Racial disparities in receipt of guideline concordant pancreatic cancer care among older adults in the US.

• DOI: 10.1200/jco.2025.43.4_suppl.679
• Publication Date: 2025-01-27T14:37:03Z
• Authors: Joshua Herb; Kai-Ping Eric Liao; Kever Lewis; Matthew H. G. Katz; John Kent Lin; Rebecca A Snyder
• Keywords: Receipt; Guideline

679 Background: Patients racialized as Black experience higher incidence and mortality from pancreatic cancer (PC). The aim of this study was to examine differences in receipt guideline concordant care (GCC) among older adults with PC Black, White, or Hispanic ethnicity. Methods: 65 years incident ethnicity were identified the SEER-Medicare database 2004-2019. primary outcome GCC (stage I/II: surgery+chemotherapy+/-radiation; stage III: chemotherapy+/-surgery+/-radiation; IV: chemotherapy+/-radiation). Multivariable logistic regression used identify factors associated GCC. Oaxaca-Blinder decomposition contribution measured unmeasured variables racial disparities Results: Of 12,772 patients included, 85.5% White (n=10,915), 7.8% (n=992), 6.8% (n=865). more often dual-eligible for Medicare/Medicaid than (38.6%, 26.9%, 7.5%, respectively). In total, 56.3% received On adjusted analysis, less likely receive early I/II) disease compared (OR 0.66; 95% CI 0.53-0.83), but not III 0.65; 0.41-1.01) IV 0.87; 0.66-1.14) disease. No difference observed when White. Increased age dual-eligibility decreased likelihood across stages. Differences remain largely unexplained. factors, comorbidities, dual-eligibility, area level poverty contributed most disparity (Table). Conclusions: Just over half an insured population Despite increased focus on equity care, Black-White are prevalent, particularly early-stage Further studies critical address driving treatment disparities. Contributing cancer. Stage I/II Difference (White-Black) 11.6% 9.4% 4.1% Explained Age -3.0% -2.0% -1.0% Sex 0.1% 0.8% Dual-Eligibility 2.0% 3.1% Charlson Comorbidity Index 1.3% 0.2% 0.7% Area Level Poverty 2.2% -0.8% Hospital/Practice Volume 1.2% -0.3% -0.03% Region 0.4% 0.9% -0.2% Year Diagnosis -0.1% 0.5% Unexplained 7.5% 7.0% 3.0% Positive values indicate these disparity, while negative disparity.