Evidence map›Paper›PMID 42873430›Full record

ArticleAnnals of surgical oncology2026

Association of Social Determinants of Health with Delays in Diagnosis and Treatment of Resected Pancreatic Ductal Adenocarcinoma (PDAC).

Muhammad Maisam Ali, Yazan M Hammad, Ping Zhu, Manar Z Al Rubaye, Benjamin Ay Cher, Clayton T Marcinak, Noelle K LoConte, Kamran Idrees, Patrick R Varley, Syed Nabeel Zafar

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Muhammad Maisam AliDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Yazan M HammadDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Ping ZhuDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Manar Z Al RubayeDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Benjamin Ay CherDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Clayton T MarcinakDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Noelle K LoConteDivision of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Kamran IdreesDivision of Surgical Oncology and Endocrine Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Patrick R VarleyDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Syed Nabeel ZafarDivision of Surgical Oncology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. zafars@surgery.wisc.edu.ORCID http://orcid.org/0000-0003-3843-9687

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelayed diagnosis and treatment worsen survival in pancreatic ductal adenocarcinoma (PDAC). Despite many potential causes, the influence of social determinants of health (SDoH) is understudied. We evaluated whether SDoH impact delays in diagnosis and treatment among patients who underwent resection for PDAC. PATIENTS AND

methodsAdults resected at a high-volume center were included (January 2016-November 2024). SDoH included insurance status, census-level income and education, rural-urban residence, and Area Deprivation Index. Primary endpoints were time from first imaging to histological diagnosis and time from first imaging to treatment initiation. Delay thresholds were derived using receiver operating characteristic analysis against overall survival. Uni- and multivariable logistic regression identified factors associated with delays, adjusting for demographic and clinical covariates, stratified by outpatient (OUP) versus emergency room (ER) presentation.

resultsAmong 317 patients, the median age was 67 years, and 42.3% were female; 50.1% presented through ER. The median imaging-to-diagnosis interval was 11 days (interquartile [IQR] 3-27 days), and the median imaging-to-treatment interval was 40 days (IQR 27-59 days). In the OUP cohort, Medicare insurance was associated with delayed diagnosis compared with private insurance (OR 3.34 [95% CI 1.09-11.70]), whereas higher income was associated with up to 84% lower odds of delayed treatment. In the ER cohort, higher education was associated with reduced odds of delayed diagnosis (OR 0.27 [95% CI 0.07-0.88]) and delayed treatment (OR 0.33 [95% CI 0.11-0.91]). Post-endoscopic retrograde cholangiopancreatography (ERCP) hospitalization predicted delays in the ER setting, whereas alarm symptoms reduced delays in both settings.

conclusionsSDoH are associated with diagnostic and treatment delays in resected PDAC. Targeted interventions may accelerate care and improve equity in outcomes.

Indexed as

Diagnostic delayPancreatic cancerSocial determinants of healthTime-to-treatment

Identifiers

PMID42873430

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