TOPLINE

In a nationwide Dutch study, lower household income was associated with receiving less anticancer treatment and worse survival in patients with localised pancreatic adenocarcinoma, and the distance to the hospital was negatively associated with the likelihood of receiving resection and subsequent treatment.

METHODOLOGY

• Researchers conducted a nationwide retrospective study of 5926 adults aged 18 years or older with localised pancreatic adenocarcinoma using data from the Netherlands Cancer Registry from 2017 to 2022.
• Patients were categorised into three household income groups on the basis of the median annual household income: lowest (< 24,300 euros), intermediate (24,300-31,000 euros), and highest (> 31,000 euros), with 2019 used as the index year.
• Participants were also divided into two distance groups on the basis of the median distance from their home postal code to the hospital (< 14 vs > 14 km) at which the main treatment was received.
• The researchers assessed the effect of household income and distance to the hospital on receiving anticancer treatment (upfront chemotherapy, resection of primary tumour, and adjuvant chemotherapy) and survival.

TAKEAWAY

• Patients from intermediate and highest household income groups had a higher likelihood of receiving upfront chemotherapy than those from the lowest household income group (intermediate vs lowest: odds ratio [OR], 1.23; P = .005; highest vs lowest: OR, 1.37; P < .001).
• Similarly, patients from intermediate and highest household income groups were more likely to undergo resection than those from the lowest household income group (intermediate vs lowest: OR, 1.28; P < .001; highest vs lowest: OR, 1.62; P < .001), and those living closer than 14 km from the hospital had a higher likelihood of resection (OR, 1.44; 95% CI, 1.28-1.63; P < .001).
• Patients in the lowest household income group had poorer survival than those in the highest household income group after adjusting for confounders (hazard ratio [HR], 0.91; 95% CI, 0.85-0.98; P < .001), but survival differences disappeared after additional adjustment for treatment (HR, 1.05; P = .169).
• Among patients who underwent resection, median overall survival did not differ significantly between the household income groups (lowest, 23 months; intermediate, 24 months; and highest, 25 months; P = .110).
• The distance to the hospital was not independently associated with survival after adjustment.

IN PRACTICE

"Lower household income negatively impacts the likelihood of receiving treatment for patients with pancreatic adenocarcinoma. Additionally, distance to hospital is negatively associated with the probability of receiving resection and subsequent treatment," the authors wrote. "Future studies should aim to mitigate socioeconomic and geographic barriers by optimizing patient selection for surgery and chemotherapy, ensuring that all eligible patients with localized pancreatic adenocarcinoma receive appropriate treatment," they added.

SOURCE

The study was led by Nanske C. Biesma, Department of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Utrecht University, Utrecht, Netherlands. It was published online on July 24, 2026, in the European Journal of Cancer.

LIMITATIONS

The retrospective design introduced confounding by indication. Household income was the only social measure available, so deprivation was incompletely captured. Information on referral patterns and hospital transfers was unavailable. Additionally,clinical staging was used in some non-resected patients, which may have caused misclassification.

DISCLOSURES

This study did not receive any specific funding from agencies in the public, commercial, or not-for-profit sectors. Data regarding conflicts of interest were not specified in this study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.