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Better quality pancreatic cancer care received in metropolitan and higher socio-economic areas

QIMR Berghofer researchers have found that pancreatic cancer patients living in metropolitan centres and areas with a high socio-economic status receive better-quality medical care, which is associated with improved survival.

The study involved 1,571 patients from Queensland and New South Wales who were diagnosed with pancreatic cancer between July 2009 and July 2011. It was a collaboration with researchers from Cancer Council NSW and various hospitals in Queensland and NSW.

Researchers gave the patients a quality-of-care score based on factors including the access they had to different services, the treatment they were offered, what sort of specialist doctor they were seen by, whether they participated in a clinical trial, and whether they were reviewed at a multi-disciplinary team meeting.

The head of QIMR Berghofer’s Cancer Aetiology and Prevention Laboratory, Associate Professor Rachel Neale, said it was believed to be the first time Australian researchers had calculated a single score to describe the quality of the care provided to pancreatic cancer patients.

“We found that patients living in major cities had scores 11 per cent higher than those living in rural areas,” Associate Professor Neale said.

“Patients living in areas with the highest socio-economic status had scores eight per cent higher than those living in areas with the lowest socio-economic status. And younger patients scored better than older patients.

“Finally, we found that patients who were treated in hospitals that see a large number (30 or more) of pancreatic cancer patients per year received higher scores than those who were treated in hospitals that saw a small number (fewer than 10) each year.”

Significantly, patients with higher scores lived for longer than patients with lower scores.

Associate Professor Neale said the differences in scores were partly explained by the availability of specialist doctors and multi-disciplinary teams in hospitals and in areas of residence.

“Patients who were treated in hospitals that care for a lot of pancreatic cancer patients were more likely to be seen by a specialist surgeon, rather than a general surgeon, and were more likely to be treated by a multi-disciplinary team. These hospitals are usually located in metropolitan centres,” she said.

“Pancreatic cancer is very difficult to treat and requires highly specialised care. Our results show that receiving high-quality medical care does make a difference to a patient’s outcome.

“These results suggest that strategies should be developed to ensure that all patients with pancreatic cancer have the opportunity to be evaluated by and treated in, or in conjunction with, major hospitals that treat the cancer often.”

Pancreatic cancer is the 10th most common cancer in Australia and the fourth most common cause of cancer-related deaths. Only 20 per cent of patients survive for 12 months after being diagnosed.

The study has been published today in the Medical Journal of Australia. It was funded by the National Health and Medical Research Council.