ASSOCIATION OF RURAL RESIDENCE AND TIME TO DIAGNOSIS AND TREATMENT IN PATIENTS WITH PANCREATIC ADENOCARCINOMA
Daniyal Abbas*, Toni Madugu, Rana Mohamed, Prashant Mudireddy, Scarlett Hao, Ashley Wercholuk, Alexander Parikh, Rebecca A. Snyder
Internal Medicine, East Carolina University, Greenville, NC
Introduction:
Rural residence has been associated with a more advanced stage at presentation and worse survival in patients with pancreatic adenocarcinoma (PDAC). The purpose of this study was to determine if the time from presentation to diagnosis and treatment differs among patients with pancreatic cancer residing in rural compared to urban communities.
Methods:
A retrospective cohort study was performed of all patients with PDAC who presented to a large tertiary medical center from 2015-2020 in Eastern North Carolina (ENC). The patient residence was categorized as rural or urban/suburban by census tract according to rural-urban commuting area codes. Primary outcomes included time from presentation to tissue diagnosis and time from diagnosis to initial treatment. Secondary outcomes included AJCC stage at diagnosis and time from presentation to endoscopic ultrasound (EUS) and/or endoscopic retrograde cholangiopancreatography (ERCP). Median time to treatment was compared between cohorts using Wilcoxon Rank-Sum Test.
Results:
A total of 317 patients were identified, including 163 (51.4%) rural and 154 (48.6%) urban/suburban. AJCC stage at presentation did not differ by rural or urban residence (p= 0.96). Median time from clinical presentation to diagnosis was 6 vs. 5 days in rural and urban patients respectively (p=0.37). Median time from diagnosis to first treatment was the same in rural and urban patients (22 days, p=0.22). No difference in median time from presentation to EUS or ERCP was identified according to patient residence.
Conclusions:
In patients presenting to a tertiary, regional medical system, the rural residence does not appear to be associated with increased time to diagnosis or treatment. Further research is warranted to investigate rural-urban disparities in patients presenting to non-tertiary rural hospitals.
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