Abstract B110: Racial disparities in pancreatic adenocarcinoma survival. Do they exist for patients who already survived their first year?

Although care of patients with heart failure (HF) has improved in the past decade, important disparities in HF outcomes persist based on race/ethnicity. Age-adjusted HF-related cardiovascular disease death rates are higher for Black patients, particularly among young Black men and women whose rates of death are 2.6- and 2.97-fold higher, respectively, than White men and women. Similarly, the rate of HF hospitalization for Black men and women is nearly 2.5-fold higher when compared with Whites, with costs that are significantly higher in the first year after HF hospitalization. While the relative rate of HF hospitalization has improved for other race/ethnic minorities, the disparity in HF hospitalization between Black and White patients has not decreased during the last decade. Although access to care and socioeconomic status have been traditional explanations for the observed racial disparities in HF outcomes, contemporary data suggest that novel factors including genetic susceptibility as well as social determinants of health and implicit bias may play a larger role in health outcomes than previously appreciated. The purpose of this review is to describe the complex interplay of factors that influence racial disparities in HF incidence, prevalence, and disease severity, with a highlight on evolving knowledge that will impact the clinical care and address future research needs to improve HF disparities in Blacks.

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Impact of a multidisciplinary cancer care program and nurse navigation on pancreatic adenocarcinoma treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.200 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 200-200

Author(s):

Laurence E. McCahill ◽

Mary May ◽

Coralyn Martinez ◽

Wendy K. Taylor ◽

Alan T. Davis

Keyword(s):

Pancreatic Adenocarcinoma ◽

Stage I ◽

First Year ◽

Evidence Based ◽

Newly Diagnosed ◽

Physician Visits ◽

Cancer Program ◽

Gi Cancer ◽

Nurse Navigator ◽

The Impact

200 Background: Treatment of pancreatic adenocarcinoma (PanCa) is complex and requires input from multiple physicians. We developed a unique gastrointestinal (GI) cancer program utilizing a multidisciplinary conference, a multidisciplinary clinic (MDC), a GI nurse navigator (NN) and continuous quality assessment with a nurse clinical auditor. The impact of this program, which requires significant additional resources, on adherence to evidence based cancer treatment for newly diagnosed PanCa patients is unknown. Methods: The GI (NN) interviews patients, coordinates staging and biopsies, physician visits and subsequent adjuvant care in the first year of diagnosis. A clinical quality specialist abstracted all treatment received (surgical, radiation, chemotherapy, palliative), and data was entered into a GI Quality database. Treatment received by patients in first year of diagnosis was compared to NCCN guidelines. Results: From January 2010 to April 2012, 68 patients with newly diagnosed PanCA were evaluated/treated. Overall compliance with NCCN treatment guidelines was 83.4%. Compliance was highest for stage I (almost all underwent surgical resection) and stage IV (none underwent surgery). Utilization of adjuvant therapies was 80% (16/20) for patients with stageI/II disease. Eight patients with stage I/II disease did not undergo surgery, due to comorbidities or disease progression. Conclusions: A novel GI cancer program utilizing a multispecialty MDC and a dedicated GI NN demonstrates very high compliance with evidence based therapy for first line treatment for PanCa patients. Although resource intensive, this level of adherence to evidence-based medicine is encouraging and higher than prior reports for PanCa. The relative contribution of the GI MDC clinic format versus the NN warrants further study. [Table: see text]

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Racial disparities in survival among patients with resected pancreatic adenocarcinoma and pancreatic neuroendocrine tumor. Miami-based population study.

HPB ◽

10.1016/j.hpb.2018.02.533 ◽

2018 ◽

Vol 20 ◽

pp. S130-S131

Author(s):

B. Azab ◽

D. Yakoub

Keyword(s):

Racial Disparities ◽

Neuroendocrine Tumor ◽

Pancreatic Adenocarcinoma ◽

Population Study ◽

Pancreatic Neuroendocrine Tumor

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Treatment at a high-volume academic research program mitigates racial disparities in pancreatic adenocarcinoma

Journal of Gastrointestinal Oncology ◽

10.21037/jgo-20-584 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Quyen D. Chu ◽

Mei-Chin Hsieh ◽

John F. Gibbs ◽

Xiao-Cheng Wu

Keyword(s):

Racial Disparities ◽

Pancreatic Adenocarcinoma ◽

Research Program ◽

Academic Research ◽

High Volume

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Racial Disparities in Sugar-Sweetened Beverage Consumption Change Efficacy Among Male First-Year College Students

American Journal of Men s Health ◽

10.1177/1557988315599825 ◽

2016 ◽

Vol 10 (6) ◽

pp. NP168-NP175 ◽

Cited By ~ 5

Author(s):

Marino A. Bruce ◽

Bettina M. Beech ◽

Roland J. Thorpe ◽

Derek M. Griffith

Keyword(s):

College Students ◽

African American ◽

Racial Disparities ◽

African American Males ◽

Self Efficacy ◽

First Year ◽

Sugar Sweetened Beverage ◽

First Year College ◽

Sweetened Beverage ◽

First Year College Students

Racial disparities in weight-related outcomes among males may be linked to differences in behavioral change efficacy; however, few studies have pursued this line of inquiry. The purpose of this study was to determine the degree to which self-efficacy associated with changing sugar-sweetened beverage (SSB) consumption intake varies by race among male first-year college students. A self-administered, cross-sectional survey was completed by a subsample of freshmen males ( N = 203) at a medium-sized southern university. Key variables of interest were SSB intake and self-efficacy in reducing consumption of sugared beverages. African American and Whites had similar patterns of SSB intake (10.2 ± 2.8 vs. 10.1 ± 2.6); however, African Americans had lower proportions of individuals who were sure they could substitute sugared beverages with water (42.2% vs. 57.5%, p < .03). The results from logistic regression models suggest that self-efficacy to reduce SSB intake among males vary by race. African American males were less likely to assert confidence in their ability to change behaviors associated with SSB (odds ratio = 0.51; confidence interval [0.27, 0.95]) in the full model adjusting for weight-related variables including SSB consumption. The findings suggest that weight loss and weight prevention interventions targeting young African American males require components that can elevate self-efficacy of this group to facilitate behavioral modifications that reduce SSB consumption and their risk for obesity-related diseases.

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Racial disparities in the receipt of adjuvant chemotherapy in patients with resected stage I-III pancreatic adenocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.357 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 357-357 ◽

Cited By ~ 1

Author(s):

Nina Niu Sanford ◽

Xiaohan Xu ◽

David J. Sher

Keyword(s):

Logistic Regression ◽

Adjuvant Chemotherapy ◽

Racial Disparities ◽

Pancreatic Adenocarcinoma ◽

Cancer Survival ◽

Representative Study ◽

Multivariable Logistic Regression ◽

Black Patients ◽

Definitive Surgery ◽

To Receive

357 Background: Adjuvant chemotherapy for resected pancreatic adenocarcinoma is a category 1 NCCN recommendation, however studies have shown that many patients do not go on to receive chemotherapy after definitive surgery. Whether racial disparities exist for receipt of adjuvant chemotherapy is unknown. Methods: The National Cancer Database was used to identify 28,255 patients with non-metastatic pancreatic adenocarcinoma who underwent definitive surgery between 2005-2014. Multivariable logistic regression defined adjusted odds ratio (AOR) and 95% confidence intervals (CI) of receipt of adjuvant chemotherapy by race. Additional variables included in the model were age, sex, stage, node positivity, comorbidity index, facility type and insurance. Among those receiving chemotherapy, multivariable logistic regression assessed odds of treatment with multiagent chemotherapy and among those not receiving chemotherapy, predictors of chemotherapy refusal were assessed. Results: Compared to white patients, black patients were less likely to receive adjuvant chemotherapy (AOR 0.74, 95% CI 0.64-0.85, p < 0.001) and multiagent adjuvant chemotherapy (AOR 0.80, 95% CI 0.72-0.88, p < 0.001). The disparities were limited to patients with comorbidity score of 0 and persisted when analyses were restricted to only academic cancer centers. Among 2,405 patients not treated with chemotherapy, black patients had lower odds of refusing chemotherapy (AOR 0.72, 95% CI 0.55-0.93, p = 0.01). Conclusions: In this nationally representative study, black patients were less likely to receive NCCN-guideline concordant treatment for resected pancreatic adenocarcinoma; this disparity did not appear to be driven by increased refusal of treatment by black patients. Given that differences in quality of care may contribute to disparities in cancer survival, our findings suggest that outcomes for black patients could be improved by increasing the proportion receiving guideline-concordant adjuvant chemotherapy. Further investigation is needed to identify factors leading to the observed differences in this study, such that appropriate interventions can be undertaken to mitigate this disparity.

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