Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil

Abstract 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....

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Autores principales:	Victor Hugo Fonseca de Jesus, Wilson Luiz da Costa, Laura Carolina Lopez Claro, Felipe José Fernandez Coimbra, Aldo Lourenço Abbade Dettino, Rachel P. Riechelmann, Maria Paula Curado
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dbe0883691f048a186b353e69a7698c5
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spelling	oai:doaj.org-article:dbe0883691f048a186b353e69a7698c52021-12-02T16:30:05ZDisparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil10.1038/s41598-021-85759-52045-2322https://doaj.org/article/dbe0883691f048a186b353e69a7698c52021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85759-5https://doaj.org/toc/2045-2322Abstract 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.Victor Hugo Fonseca de JesusWilson Luiz da CostaLaura Carolina Lopez ClaroFelipe José Fernandez CoimbraAldo Lourenço Abbade DettinoRachel P. RiechelmannMaria Paula CuradoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Victor Hugo Fonseca de Jesus Wilson Luiz da Costa Laura Carolina Lopez Claro Felipe José Fernandez Coimbra Aldo Lourenço Abbade Dettino Rachel P. Riechelmann Maria Paula Curado Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
description	Abstract 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.
format	article
author	Victor Hugo Fonseca de Jesus Wilson Luiz da Costa Laura Carolina Lopez Claro Felipe José Fernandez Coimbra Aldo Lourenço Abbade Dettino Rachel P. Riechelmann Maria Paula Curado
author_facet	Victor Hugo Fonseca de Jesus Wilson Luiz da Costa Laura Carolina Lopez Claro Felipe José Fernandez Coimbra Aldo Lourenço Abbade Dettino Rachel P. Riechelmann Maria Paula Curado
author_sort	Victor Hugo Fonseca de Jesus
title	Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
title_short	Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
title_full	Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
title_fullStr	Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
title_full_unstemmed	Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil
title_sort	disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the state of são paulo, brazil
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dbe0883691f048a186b353e69a7698c5
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Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil

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