The impact of socioeconomic factors on pancreatic cancer care utilization

Background: Pancreatic cancer carries a dismal prognosis, with socioeconomic factors significantly impacting patient outcomes. This study investigates the influence of socioeconomic determinants on access to specialized pancreatic cancer care and utilization rates in southeast Wisconsin. Methods: We analyzed a dataset of 5,847 pancreatic cancer patients from the Froedtert & the Medical College of Wisconsin health system (2000-2023). Patient demographics were compared to the broader health system population. Utilization of specialized pancreatic cancer care was calculated for each patient’s zip code of residence. Linear and multivariate regression analyses were conducted to assess the association between socioeconomic factors (white population, income, education, insurance, Area Deprivation Index) and zip code-level utilization rates. Results: Pancreatic cancer patients were older (mean age 66.3 vs. 46.5 years), predominantly male (52.7%), and disproportionately White (83.2% vs 63.6%) compared to the general population. Notably, patients residing in zip codes with the lowest median household income ( $87,000) showed a 0.14% rate. Interestingly, utilization dipped to its lowest point (0.068%) in areas with median incomes between $53,100-$59,300. Initial analysis suggested that higher education levels, private insurance, and higher median incomes were linked to increased utilization. However, after accounting for other factors, only the Area Deprivation Index (ADI) and the percentage of the White population remained significant predictors. Specifically, a one-unit increase in ADI (indicating greater neighborhood disadvantage) was associated with a 0.0015% decrease in specialized care utilization (p