Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
| Autor: | Laura Carolina Lopez Claro, Felipe José Fernandez Coimbra, Maria Paula Curado, Rachel P. Riechelmann, Wilson Luiz da Costa, Aldo Lourenço Abbade Dettino, Victor Hugo Fonseca de Jesus |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Science Disease Article Health Services Accessibility Young Adult 03 medical and health sciences Cancer epidemiology 0302 clinical medicine Interquartile range Internal medicine Pancreatic cancer Health care Carcinoma medicine Humans 030212 general & internal medicine Healthcare Disparities Aged Data Management Proportional Hazards Models Aged 80 and over Multidisciplinary business.industry Proportional hazards model Middle Aged medicine.disease Confidence interval Pancreatic Neoplasms 030220 oncology & carcinogenesis Medicine Population study Female business Delivery of Health Care Brazil |
| Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-85759-5 |
| Popis: | Little is known about the features and outcomes of Brazilian patients with pancreatic cancer. We sought to describe the socio-economic characteristics, patterns of health care access, and survival of patients diagnosed with malignant pancreatic tumors from 2000 to 2014 in São Paulo, Brazil. We included patients with malignant exocrine and non-classified pancreatic tumors according to the International Classifications of Disease (ICD)-O-2 and -O-3, diagnosed from 2000 to 2014, who were registered in the FOSP database. Prognostic factors for overall survival (OS) in the subgroup of patients with ductal or non-specified (adeno)carcinoma were evaluated using Cox proportional hazard model. The study population consists of 6855 patients. Median time from the first visit to diagnosis and treatment were 13 (Interquartile range [IQR] 4–30) and 24 (IQR 8–55) days, respectively. Both intervals were longer for patients treated in the public setting. Median OS was 4.9 months (95% confidence interval [95% CI] 4.7–5.2). Increasing age, male gender, lower educational level, treatment in the public setting, absence of treatment, advanced stage, and treatment from 2000 to 2004 were associated with inferior OS. From 2000–2004 to 2010–2014, no improvement in OS was seen for patients treated in the public setting. Survival of patients with malignant pancreatic tumors remains dismal. Socioeconomical variables, especially health care funding, are major determinants of survival. Further work is necessary to decrease inequalities in access to medical care for patients with pancreatic cancer in Brazil. |
| Databáze: | OpenAIRE |
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