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Regional and socio-economic variation in survival after a pancreatic cancer diagnosis in Denmark

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Henriette Engberg, Marianne Steding-Jessen, Inge Øster, Jens Winther Jensen, Claus Wilki Fristrup, Henrik Møller

Original languageEnglish
Article numberA08190438
JournalDanish Medical Journal
Volume67
Issue number2
Published1 Feb 2020

Bibliographical note

Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Abstract

Introduction: Pancreatic cancer is among the most lethal malignancies with a five-year survival of about 5%, and the only curative treatment is surgical resection. Denmark consists of five governmental regions and has four surgical centres. Our aim was to explore the regional and socio-economic differences in overall survival following a pancreatic cancer diagnosis in Denmark. Methods: We included a total of 5,244 pancreatic cancer patients (WHO International Classification of Diseases, tenth version C25) registered in the Danish Pancreatic Cancer Database during 2012-2017. The data sources used were the Danish Civil Registration System, the Danish National Patient Registry and the Danish national registers on education and income at Statistics Denmark. Cox regression analysis was used to examine all-cause mortality of pancreatic cancer patients by region of residence and socio-economic status. Results: Compared to The Capital Region, there was an excess mortality in the Central Denmark Region and the North Denmark Region in both men and women, whereas no increased mortality was observed in the Region of Southern Denmark or in Region Zealand. Estimates were adjusted for age, year of diagnosis and comorbidity. Adjustment for surgical resection greatly attenuated the variation in survival between the regions. Conclusions: We found significant differences in overall survival across the five Danish regions following a diagnosis of pancreatic cancer. The regional variation in survival was largely attributable to differences in the propensity to use surgical resection.

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