Factors Associated With Pancreatectomy Among Australians With Pancreatic Cancer: A Population-Based Study

Area of Science:

• Oncology
• Surgical Oncology
• Health Services Research

Background:

• Pancreatectomy offers a potential cure for pancreatic cancer.
• Accessibility to pancreatectomy varies across Australia.
• Sociodemographic, healthcare, and patient factors influence pancreatectomy access.

Purpose of the Study:

• To explore factors associated with undergoing pancreatectomy for pancreatic cancer.
• To analyze trends in pancreatectomy uptake.
• To identify disparities in access to this curative treatment.

Main Methods:

• Utilized a national linked dataset from the Australian Institute of Health and Welfare (2010-2018).
• Analyzed pancreatic cancer patient data (excluding WA and NT).
• Employed Joinpoint regression for trend analysis and log-binomial regression for factor associations, including causal mediation analysis.

Main Results:

• 15% of 22,739 pancreatic cancer patients underwent pancreatectomy; uptake increased by 1.36% bi-annually.
• Older age (80+ vs. 60-69 years: PR=0.16), remote areas (PR=0.59), and socioeconomic disadvantage (PR=0.75) were linked to lower prevalence.
• Private specialist visits (PR=1.60) and GP visits were associated with higher prevalence, with specialist visits mediating regional and GP visit disparities.

Conclusions:

• Pancreatectomy access is significantly influenced by sociodemographic, clinical, and healthcare factors.
• Understanding these influencing factors is critical for improving equitable access to pancreatic cancer treatment.
• Targeted interventions may be needed to address disparities in pancreatectomy uptake.