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Erschienen in: World Journal of Surgery 2/2017

06.09.2016 | Original Scientific Report

Treatment Access and Survival Amongst British Asians with Pancreatic Cancer

Erschienen in: World Journal of Surgery | Ausgabe 2/2017

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Abstract

Introduction

Despite increasingly mixed communities in large cities, there remains a paucity of absolute and comparative data concerning the treatment, access and survival of British Asians with pancreatic cancer.

Methods

A prospective database of 1038 patients with a diagnosis of pancreatic cancer from 2003 to 2012 was analysed. Asian/Asian British was defined as patients identifying themselves as originating from India, Bangladesh or Pakistan.

Results

No significant difference was observed in gender split for both Asian/Asian British and White British (AAB and WB). The incidence of pancreas cancer was also equivalent between the two groups at 8.1 versus 8.8 per 100,000 of the population. Age at presentation was significantly younger in AABs when compared to WBs (67 vs. 70 years, p = 0.003). Whilst median maximal tumour diameter, node status and the incidence of metastases were not different between AABs and WBs, the AABs had a significantly greater median T-stage (3.0 versus 2.5, p = 0.0024). The percentage of patients referred for chemotherapy was significantly higher in the AAB group (70.5 vs. 47.7 %, p = 0.0015). Overall survival and survival for patients having palliative treatment were significantly greater in AABs (4.6 vs. 6.1 months and 3.7 vs. 5.1 months).

Conclusion

This study demonstrates that AAB patients are present with pancreatic cancer at a younger age and that when receiving palliative chemotherapy their survival is significantly better. Further studies and larger data sets over a longer period are required. It is important to examine further the complexity of incidence and survival in ethnic minorities and investigate the underlying reasons when differences are demonstrated.
Literatur
1.
Zurück zum Zitat Office for National Statistics (2007) Mortality Statistics: cause. England and Wales. Office for National Statistics, London Office for National Statistics (2007) Mortality Statistics: cause. England and Wales. Office for National Statistics, London
2.
Zurück zum Zitat Office for National Statistics (2011) Population Estimates by Ethnic Group. Office for National Statistics, London Office for National Statistics (2011) Population Estimates by Ethnic Group. Office for National Statistics, London
3.
Zurück zum Zitat Ali R, Barnes I, Cairns BJ, Finlayson AE, Bhala N, Mallath M et al (2012) Incidence of gastrointestinal cancers by ethnic group in England, 2001-2007. Gut 62(12):1692–1703CrossRefPubMed Ali R, Barnes I, Cairns BJ, Finlayson AE, Bhala N, Mallath M et al (2012) Incidence of gastrointestinal cancers by ethnic group in England, 2001-2007. Gut 62(12):1692–1703CrossRefPubMed
4.
Zurück zum Zitat Baradaran HR, Sayeed S, Barnes I, Cairns BJ, Finlayson A, Ali R (2013) Childhood Cancer Incidence in British Indians & Whites in Leicester, 1996–2008. PLoS ONE 8(4):e61881CrossRef Baradaran HR, Sayeed S, Barnes I, Cairns BJ, Finlayson A, Ali R (2013) Childhood Cancer Incidence in British Indians & Whites in Leicester, 1996–2008. PLoS ONE 8(4):e61881CrossRef
5.
Zurück zum Zitat Office for National Statistics (2012) Regional Profiles: Key Statistics—East Midlands. Office for National Statistics, London Office for National Statistics (2012) Regional Profiles: Key Statistics—East Midlands. Office for National Statistics, London
6.
Zurück zum Zitat Du XL, Meyer TE, Franzini L (2007) Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer 109(11):2161–2170CrossRefPubMed Du XL, Meyer TE, Franzini L (2007) Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer 109(11):2161–2170CrossRefPubMed
7.
Zurück zum Zitat Eloubeidi MA, Desmond RA, Wilcox CM, Wilson RJ, Manchikalapati P, Fouad MM et al (2006) Prognostic factors for survival in pancreatic cancer: a population-based study. Am J Surg 192(3):322–329CrossRefPubMed Eloubeidi MA, Desmond RA, Wilcox CM, Wilson RJ, Manchikalapati P, Fouad MM et al (2006) Prognostic factors for survival in pancreatic cancer: a population-based study. Am J Surg 192(3):322–329CrossRefPubMed
8.
Zurück zum Zitat Singal V, Singal AK, Kuo YF (2012) Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis. J Cancer Res Clin Oncol 138(4):715–722CrossRefPubMed Singal V, Singal AK, Kuo YF (2012) Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis. J Cancer Res Clin Oncol 138(4):715–722CrossRefPubMed
11.
Zurück zum Zitat Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474CrossRefPubMed Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474CrossRefPubMed
12.
Zurück zum Zitat Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed
13.
Zurück zum Zitat Hariharan D, Saied A, Kocher HM (2008) Analysis of mortality rates for pancreatic cancer across the world. HPB (Oxford) 10(1):58–62CrossRef Hariharan D, Saied A, Kocher HM (2008) Analysis of mortality rates for pancreatic cancer across the world. HPB (Oxford) 10(1):58–62CrossRef
14.
Zurück zum Zitat Boyle P, Hsieh CC, Maisonneuve P, La Vecchia C, Macfarlane GJ, Walker AM et al (1989) Epidemiology of pancreas cancer (1988). Int J Pancreatol 5(4):327–346CrossRefPubMed Boyle P, Hsieh CC, Maisonneuve P, La Vecchia C, Macfarlane GJ, Walker AM et al (1989) Epidemiology of pancreas cancer (1988). Int J Pancreatol 5(4):327–346CrossRefPubMed
15.
Zurück zum Zitat Mack TM, Peters JM, Yu MC, Hanisch R, Wright WE, Henderson BE (1985) Pancreas cancer is unrelated to the workplace in Los Angeles. Am J Ind Med 7(3):253–266CrossRefPubMed Mack TM, Peters JM, Yu MC, Hanisch R, Wright WE, Henderson BE (1985) Pancreas cancer is unrelated to the workplace in Los Angeles. Am J Ind Med 7(3):253–266CrossRefPubMed
16.
Zurück zum Zitat Chang KJ, Parasher G, Christie C, Largent J, Anton-Culver H (2005) Risk of pancreatic adenocarcinoma: disparity between African Americans and other race/ethnic groups. Cancer 103(2):349–357CrossRefPubMed Chang KJ, Parasher G, Christie C, Largent J, Anton-Culver H (2005) Risk of pancreatic adenocarcinoma: disparity between African Americans and other race/ethnic groups. Cancer 103(2):349–357CrossRefPubMed
17.
Zurück zum Zitat Wray CJ, Castro-Echeverry E, Silberfein EJ, Ko TC, Kao LS (2012) A multi-institutional study of pancreatic cancer in Harris County, Texas: race predicts treatment and survival. Ann Surg Oncol 19(9):2776–2781CrossRefPubMed Wray CJ, Castro-Echeverry E, Silberfein EJ, Ko TC, Kao LS (2012) A multi-institutional study of pancreatic cancer in Harris County, Texas: race predicts treatment and survival. Ann Surg Oncol 19(9):2776–2781CrossRefPubMed
18.
Zurück zum Zitat Fitzgerald TL, Bradley CJ, Dahman B, Zervos EE (2009) Gastrointestinal malignancies: when does race matter? J Am Coll Surg 209(5):645–652CrossRefPubMed Fitzgerald TL, Bradley CJ, Dahman B, Zervos EE (2009) Gastrointestinal malignancies: when does race matter? J Am Coll Surg 209(5):645–652CrossRefPubMed
19.
Zurück zum Zitat Murphy MM, Simons JP, Ng SC, McDade TP, Smith JK, Shah SA et al (2009) Racial differences in cancer specialist consultation, treatment, and outcomes for locoregional pancreatic adenocarcinoma. Ann Surg Oncol 16(11):2968–2977CrossRefPubMed Murphy MM, Simons JP, Ng SC, McDade TP, Smith JK, Shah SA et al (2009) Racial differences in cancer specialist consultation, treatment, and outcomes for locoregional pancreatic adenocarcinoma. Ann Surg Oncol 16(11):2968–2977CrossRefPubMed
20.
Zurück zum Zitat Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis, Chen HS, Feuer EJ, Cronin KA (eds) (2013) SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis, Chen HS, Feuer EJ, Cronin KA (eds) (2013) SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda
21.
Zurück zum Zitat Yeole BB, Kumar AV (2004) Population-based survival from cancers having a poor prognosis in Mumbai (Bombay), India. Asian Pac J Cancer Prev 5(2):175–182PubMed Yeole BB, Kumar AV (2004) Population-based survival from cancers having a poor prognosis in Mumbai (Bombay), India. Asian Pac J Cancer Prev 5(2):175–182PubMed
22.
Zurück zum Zitat Harding S, Rosato M, Teyhan A (2009) Trends in cancer mortality among migrants in England and Wales, 1979-2003. Eur J Cancer 45(12):2168–2179CrossRefPubMed Harding S, Rosato M, Teyhan A (2009) Trends in cancer mortality among migrants in England and Wales, 1979-2003. Eur J Cancer 45(12):2168–2179CrossRefPubMed
23.
Zurück zum Zitat Arnold LD, Patel AV, Yan Y, Jacobs EJ, Thun MJ, Calle EE et al (2009) Are racial disparities in pancreatic cancer explained by smoking and overweight/obesity? Cancer Epidemiol Biomarkers Prev 18(9):2397–2405CrossRefPubMedPubMedCentral Arnold LD, Patel AV, Yan Y, Jacobs EJ, Thun MJ, Calle EE et al (2009) Are racial disparities in pancreatic cancer explained by smoking and overweight/obesity? Cancer Epidemiol Biomarkers Prev 18(9):2397–2405CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Genkinger JM, Spiegelman D, Anderson KE, Bergkvist L, Bernstein L, van den Brandt PA et al (2009) Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies. Cancer Epidemiol Biomarkers Prev 18(3):765–776CrossRefPubMedPubMedCentral Genkinger JM, Spiegelman D, Anderson KE, Bergkvist L, Bernstein L, van den Brandt PA et al (2009) Alcohol intake and pancreatic cancer risk: a pooled analysis of fourteen cohort studies. Cancer Epidemiol Biomarkers Prev 18(3):765–776CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Shi C, Hruban RH, Klein AP (2009) Familial pancreatic cancer. Arch Pathol Lab Med 133(3):365–374PubMed Shi C, Hruban RH, Klein AP (2009) Familial pancreatic cancer. Arch Pathol Lab Med 133(3):365–374PubMed
27.
Zurück zum Zitat Pernick NL, Sarkar FH, Philip PA, Arlauskas P, Shields AF, Vaitkevicius VK et al (2003) Clinicopathologic analysis of pancreatic adenocarcinoma in African Americans and Caucasians. Pancreas 26(1):28–32CrossRefPubMed Pernick NL, Sarkar FH, Philip PA, Arlauskas P, Shields AF, Vaitkevicius VK et al (2003) Clinicopathologic analysis of pancreatic adenocarcinoma in African Americans and Caucasians. Pancreas 26(1):28–32CrossRefPubMed
28.
Zurück zum Zitat Ahrendt SA, Decker PA, Alawi EA, Zhu Yr YR, Sanchez-Cespedes M, Yang SC et al (2001) Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung. Cancer 92(6):1525–1530CrossRefPubMed Ahrendt SA, Decker PA, Alawi EA, Zhu Yr YR, Sanchez-Cespedes M, Yang SC et al (2001) Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung. Cancer 92(6):1525–1530CrossRefPubMed
29.
Zurück zum Zitat Silverman DT, Hoover RN, Brown LM, Swanson GM, Schiffman M, Greenberg RS et al (2003) Why do Black Americans have a higher risk of pancreatic cancer than White Americans? Epidemiology 14(1):45–54CrossRefPubMed Silverman DT, Hoover RN, Brown LM, Swanson GM, Schiffman M, Greenberg RS et al (2003) Why do Black Americans have a higher risk of pancreatic cancer than White Americans? Epidemiology 14(1):45–54CrossRefPubMed
30.
Zurück zum Zitat Jemal A, Simard EP, Xu J, Ma J, Anderson RN (2013) Selected cancers with increasing mortality rates by educational attainment in 26 states in the United States, 1993–2007. Cancer Causes Control 24(3):559–565CrossRefPubMed Jemal A, Simard EP, Xu J, Ma J, Anderson RN (2013) Selected cancers with increasing mortality rates by educational attainment in 26 states in the United States, 1993–2007. Cancer Causes Control 24(3):559–565CrossRefPubMed
31.
Zurück zum Zitat Byers TE, Wolf HJ, Bauer KR, Bolick-Aldrich S, Chen VW, Finch JL et al (2008) The impact of socioeconomic status on survival after cancer in the United States: findings from the National Program of Cancer Registries Patterns of Care Study. Cancer 113(3):582–591CrossRefPubMed Byers TE, Wolf HJ, Bauer KR, Bolick-Aldrich S, Chen VW, Finch JL et al (2008) The impact of socioeconomic status on survival after cancer in the United States: findings from the National Program of Cancer Registries Patterns of Care Study. Cancer 113(3):582–591CrossRefPubMed
32.
Zurück zum Zitat Chu KC, Miller BA, Springfield SA (2007) Measures of racial/ethnic health disparities in cancer mortality rates and the influence of socioeconomic status. J Natl Med Assoc 99(10):1092–100, 1102–4PubMed Chu KC, Miller BA, Springfield SA (2007) Measures of racial/ethnic health disparities in cancer mortality rates and the influence of socioeconomic status. J Natl Med Assoc 99(10):1092–100, 1102–4PubMed
33.
Zurück zum Zitat Freeman HP, Chu KC (2005) Determinants of cancer disparities: barriers to cancer screening diagnosis and treatment. Surg Oncol Clin N Am 14(4):655–69, vCrossRefPubMed Freeman HP, Chu KC (2005) Determinants of cancer disparities: barriers to cancer screening diagnosis and treatment. Surg Oncol Clin N Am 14(4):655–69, vCrossRefPubMed
34.
Zurück zum Zitat Morris AM, Rhoads KF, Stain SC, Birkmeyer JD (2010) Understanding racial disparities in cancer treatment and outcomes. J Am Coll Surg 211(1):105–113CrossRefPubMed Morris AM, Rhoads KF, Stain SC, Birkmeyer JD (2010) Understanding racial disparities in cancer treatment and outcomes. J Am Coll Surg 211(1):105–113CrossRefPubMed
35.
Zurück zum Zitat Pulte D, Redaniel MT, Brenner H, Jeffreys M (2012) Changes in survival by ethnicity of patients with cancer between 1992–1996 and 2002–2006: is the discrepancy decreasing? Ann Oncol 23(9):2428–2434CrossRefPubMed Pulte D, Redaniel MT, Brenner H, Jeffreys M (2012) Changes in survival by ethnicity of patients with cancer between 1992–1996 and 2002–2006: is the discrepancy decreasing? Ann Oncol 23(9):2428–2434CrossRefPubMed
Metadaten
Titel
Treatment Access and Survival Amongst British Asians with Pancreatic Cancer
Publikationsdatum
06.09.2016
Erschienen in
World Journal of Surgery / Ausgabe 2/2017
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3707-7

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