Describing Patterns of Care in Pancreatic Cancer: A Population-Based Study.
OBJECTIVE
Despite pancreatic cancer being the fifth highest cause of cancer death in developed regions, there is a paucity of population-based management details for patients with pancreatic cancer. The objective of this study was to reflect on current practice and outcomes to facilitate future improvement.


METHODS
A comprehensive population-based patterns-of-care study in 2 Australian states was conducted. Patients diagnosed with pancreatic adenocarcinoma between July 2009 and June 2011 were identified by cancer registries, and detailed clinical data were collected from medical records.


RESULTS
Data were collected for 1863 patients, 96% of those eligible. The majority resided in major cities; their median age was 72 years, and 54% were men. Over half of the cases (58%) had metastatic disease at diagnosis. Resection was attempted for 20% of patients but only completed in 15%. The uptake of adjuvant chemotherapy (76%) and the proportion alive at 1-year (22%) were higher than reported in previous population-based reports. Of those with no complete surgical resection, 43% received palliative chemotherapy.


CONCLUSIONS
This population-based overview of the management of patients with pancreatic cancer suggests that, despite evidence that the proportion surviving and the use of adjuvant chemotherapy has increased, there may still be underutilization of cancer-directed therapies.
From the *Population Health, QIMR Berghofer Medical Research Institute; †University of Queensland, Brisbane, Queensland; ‡Cancer Research Division, Cancer Council NSW, Sydney; §University of Newcastle, Newcastle; ║Department of Medical Oncology, Prince of Wales Hospital; ¶University of New South Wales; #Sydney Nursing School, University of Sydney, Sydney, New South Wales; **Queensland University of Technology, Brisbane, Queensland; ††School of Medicine, University of Western Sydney, Sydney, New South Wales; and ‡‡Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland.
Elizabeth A
EA
Burmeister
Dianne L
DL
OʼConnell
Vanessa L
VL
Beesley
David
D
Goldstein
Helen M
HM
Gooden
Monika
M
Janda
Susan J
SJ
Jordan
Neil D
ND
Merrett
Madeleine E
ME
Payne
David
D
Wyld
Rachel E
RE
Neale
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods*; D011878:Radiotherapy; D012042:Registries / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative