Sociodemographic and tumor characteristics associated with pancreatic cancer surgery in the United States

Background and Objectives: Surgical resection is the only curative treatment for pancreatic cancer. The aim of this project was to compare risk and prognostic factors between pancreatic cancer patients treated with and without surgery. Methods: Data from 32,318 cases collected from 1988 to 2002 in the Surveillance Epidemiology and End Results program were used to evaluate the odds of having surgery for pancreatic adenocarcinoma. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals for the associations of demographic and tumor characteristics with surgical treatment. Results: Overall, men were less likely to have surgery than women (OR = 0.90, 95% CI 0.83, 0.98). Compared to married patients, surgery was significantly less likely among those who were divorced/separated (OR = 0.78, 95% CI 0.68, 0.89) or widowed (OR = 0.76, 95% CI 0.67, 0.85). Black patients were less likely to receive surgery than white patients (OR = 0.79, 95% CI 0.70, 0.91). Patients diagnosed in 1997-2002 were more likely to have surgery then those diagnosed in 1988-1996. Geographic differences also exist in the frequency of surgical treatment reported by different registries. Conclusions: There are differences in sociodemographic characteristics between surgically and non-surgically treated pancreatic cancers that are not entirely attributable to age, primary site, or stage at diagnosis.