ArticleCancer medicine2018
A real-world, population-based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer.
Article in Cancer medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Prognostic utility of the Charlson comorbidity index in pancreatic cancer: a systematic review and meta‑analysis.World journal of surgical oncology · 2026Pooled it
- Impact of Depression on Mortality in Patients with Pancreatic Cancer: A Systematic Review.Current oncology (Toronto, Ont.) · 2025Pooled it
- Epidemiology and survival analysis according to the histologic subtype of pancreatic cancer: a population-based cohort study.Annals of surgical treatment and research · 2025Article
- First Course of treatment and Prognosis of Exocrine Pancreatic Cancer in Korea from 2006 to 2017.Cancer research and treatment · 2022Article
- Review
- Advances in the management of pancreatic ductal adenocarcinoma.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Review
- Real-world patterns of chemotherapy administration and attrition among patients with metastatic colorectal cancer.International journal of colorectal disease · 2021Article
- Prolonged time to treatment initiation in advanced pancreatic cancer patients has no major effect on treatment outcome: a retrospective cohort study controlled for lead time bias and waiting time paradox.Journal of cancer research and clinical oncology · 2020Article
- Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study.PloS one · 2020Article
- Low rates of specialized cancer consultation and cancer-directed therapy for noncurable pancreatic adenocarcinoma: a population-based analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
- A real-world, population-based study of patterns of referral, treatment, and outcomes for advanced pancreatic cancer.Cancer medicine · 2018Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo describe patterns of referral, consultation, and treatment of advanced pancreatic cancer patients in a population-based health care system and to evaluate the impact of these factors on outcomes.
methodsThis is a retrospective analysis of population-based cancer data from the province of Alberta, Canada. We analyzed patients diagnosed with either locally advanced or metastatic pancreatic adenocarcinoma from 2009 to 2016 and evaluated their patterns of referral to a cancer center, consultation with oncology, and treatment with active anticancer therapies. Logistic regression models were constructed to determine the factors associated with referral, late oncology assessment, and late receipt of treatment.
resultsWe identified 1621 pancreatic cancer patients. Median age was 70 years, 50% were men, and 51% had a Charlson index of 2+. Within this cohort, only 884 (54%) patients were referred to one of the provincial cancer centers. Adjusting for confounders in logistic regression models, older age and worse comorbidity scores were associated with nonreferral (both P < 0.01). In multivariable analysis among treated patients, the following factors were associated with improved overall survival, including younger age, earlier stage, and better comorbidity scores (all P < 0.01). Neither referral to consultation times nor consultation to treatment times correlated with outcomes. Importantly, nonreferred patients were more likely to use acute care services, including longer total duration of hospitalizations and more frequent visits with physician specialists.
conclusionA significant proportion of patients with advanced pancreatic cancer were never referred to a cancer center. Nonreferred patients were more likely to utilize specific health care resources.
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