350 Background: Though the role of radiation oncologists (RO) in the curative treatment of pancreatic cancer (PC) is not well defined, RO are important for the multidisciplinary care of cancer patients. The impact of this variation on PC outcomes remains unexplored. The goal of this study was to determine the effect of RO density on PC mortality. Methods: Using county-level data from the 2008 Area Resource File, National Program for Cancer Registries, and U.S. Centers for Disease Control, a multivariate regression model was constructed for PC mortality, controlling for county-level categorized RO density, demographics, socioeconomic status, and existing health care facilities. Results: There was a statistically significant reduction in PC mortality (reduction ranging from 27% to 51% p<.001) associated with counties that possessed at least one RO. Also there existed a statistically significant improvement in mortality in counties with a density of at least two RO per 100,000 people compared to counties with one radiation oncologist per 100,000 people. Conclusions: The presence of a RO is associated with lowered morality for PC within that county. In contrast to our other density analyses investigating the association between radiation oncology density and colorectal cancer and esophageal cancer mortality, the association between additional RO and PC mortality was equivocal. This may reflect the varying use of radiation oncology in different counties for the curative treatment of PC. Our study suggests that RO play an important role in the treatment of PC. [Table: see text] No significant financial relationships to disclose.
Determining desire to live among patients with advanced hepatobiliary-pancreatic cancer for whom curative treatment is not indicated
