Treatment Access and Survival Amongst British Asians with Pancreatic Cancer.
Despite increasingly mixed communities in large cities, there remains a paucity of absolute and comparative data concerning the treatment, access and survival of British Asians with pancreatic cancer.



A prospective database of 1038 patients with a diagnosis of pancreatic cancer from 2003 to 2012 was analysed. Asian/Asian British was defined as patients identifying themselves as originating from India, Bangladesh or Pakistan.



No significant difference was observed in gender split for both Asian/Asian British and White British (AAB and WB). The incidence of pancreas cancer was also equivalent between the two groups at 8.1 versus 8.8 per 100,000 of the population. Age at presentation was significantly younger in AABs when compared to WBs (67 vs. 70 years, p = 0.003). Whilst median maximal tumour diameter, node status and the incidence of metastases were not different between AABs and WBs, the AABs had a significantly greater median T-stage (3.0 versus 2.5, p = 0.0024). The percentage of patients referred for chemotherapy was significantly higher in the AAB group (70.5 vs. 47.7 %, p = 0.0015). Overall survival and survival for patients having palliative treatment were significantly greater in AABs (4.6 vs. 6.1 months and 3.7 vs. 5.1 months).



This study demonstrates that AAB patients are present with pancreatic cancer at a younger age and that when receiving palliative chemotherapy their survival is significantly better. Further studies and larger data sets over a longer period are required. It is important to examine further the complexity of incidence and survival in ethnic minorities and investigate the underlying reasons when differences are demonstrated.
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK. j.d.isherwood@outlook.com.
J
J
Isherwood
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK.
D
D
Bilku
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK.
M S
MS
Metcalfe
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK.
A R
AR
Dennison
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Gwendolen road, Leicester, LE5 4PW, UK.
G
G
Garcea
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D044466:Asian People / Q000706:statistics & numerical data*; D001459:Bangladesh / Q000208:ethnology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D007194:India / Q000208:ethnology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010154:Pakistan / Q000208:ethnology; D010166:Palliative Care / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015996:Survival Rate; D047368:Tumor Burden; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D000970:Antineoplastic Agents