ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Low rates of specialized cancer consultation and cancer-directed therapy for noncurable pancreatic adenocarcinoma: a population-based analysis.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Disparities in Access to Oncologic Care in Pancreatic Cancer: A Systematic Review.Annals of surgical oncology · 2022Pooled it
- The impact of early palliative care on the quality of life of patients with advanced pancreatic cancer: The IMPERATIVE case-crossover study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Trial
- Factors associated with physical and mental health symptoms in pancreatic adenocarcinoma: a population-based cohort study.Journal of the Canadian Association of Gastroenterology · 2026Article
- Development and Validation of a Survival Prediction Model for Patients With Pancreatic Cancer.Clinical and translational gastroenterology · 2025Article
- Neoadjuvant chemotherapy for triple-negative and Her2 +ve breast cancer: striving for the standard of care.Breast cancer research and treatment · 2024Article
- A population-based study of factors associated with systemic treatment in advanced prostate cancer decedents.Cancer medicine · 2023Article
- Initial treatment is associated with improved survival and end-of-life outcomes for patients with pancreatic cancer: a cohort study.BMC cancer · 2022Article
- First Course of treatment and Prognosis of Exocrine Pancreatic Cancer in Korea from 2006 to 2017.Cancer research and treatment · 2022Article
- The Association of Drug-Funding Reimbursement With Survival Outcomes and Use of New Systemic Therapies Among Patients With Advanced Pancreatic Cancer.JAMA network open · 2021Article
- Geographic impact on access to care and survival for non-curative esophagogastric cancer: a population-based study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2021Article
- Reducing nihilism in metastatic pancreatic ductal adenocarcinoma: Treatment, sequencing, and effects on survival outcomes.Cancer medicine · 2020Article
- Population-based study of the prevalence and management of self-reported high pain scores in patients with non-resected pancreatic adenocarcinoma.The British journal of surgery · 2019Article
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Authors and funding
9 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough advancements in systemic therapy have improved the outlook for pancreatic adenocarcinoma, it is not known if patients get access to these therapies. We aimed to examine the patterns and factors associated with access to specialized cancer consultations and subsequent receipt of cancer-directed therapy for patients with non-curative pancreatic adenocarcinoma.
methodsWe conducted a population-based analysis of noncurative pancreatic adenocarcinoma diagnosed over 2005-2016 in Ontario by linking administrative health care data sets. Our primary outcomes were specialized cancer consultation and receipt of cancer-directed therapy (chemotherapy or a combination of chemo- and radiation therapy [chemoradiation therapy]). We examined specialized cancer consultation with hepato-pancreatico-biliary surgery, medical and radiation oncology. We used multivariable logistic regression to identify factors associated with medical oncology consultation and cancer-directed therapy.
resultsOf 10 881 patients, 64.9% had a consultation with specialists in medical oncology, 35.1% with hepatopancreatico-biliary surgery and 24.7% with radiation oncology. Sociodemographic characteristics were not associated with the likelihood of medical oncology consultation. Of these patients, 4144 received cancer-directed therapy, representing 38.1% of all patients and 58.6% of those who consulted with medical oncology. Of 6737 patients not receiving cancer-directed therapy, 2988 (44.4%) had a consultation with medical oncology. Older age and lowest income quintile were independently associated with lower likelihood of cancer-directed therapy. If the first specialized cancer consultation was with medical or radiation oncology, the likelihood of cancer-directed therapy was significantly higher compared with surgery.
interpretationA considerable proportion of patients with noncurable pancreatic adenocarcinoma in Ontario did not have a specialized cancer consultation and most did not receive cancer-directed therapy. We identified disparities in specialized cancer consultation and receipt of systemic cancer-directed therapy that indicate potential gaps in assessment.
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