Regional Differences in Sociodemographic Characteristics, Stage at Diagnosis, and Access to Care Among Patients With Pancreatic Cancer

Background/Aim: Patient demographics, socioeconomic factors, and access to care vary across the United States and may contribute to differences in pancreatic cancer presentation and treatment. This study examined regional variation in demographic characteristics, socioeconomic status, stage at diagnosis, and distance traveled for care among patients with pancreatic cancer. Patients and Methods: We performed a cross-sectional analysis of the National Cancer Database, including patients diagnosed with pancreatic cancer between 2004 and 2020. Patients were categorized into six geographic regions based on the location of the treating facility: Northeast, Southeast, Midwest, Southwest, Mountain, and Pacific. Demographic, socioeconomic, clinical, and travel-distance characteristics were compared across regions. Missing values were excluded from analyses of the corresponding variables. Results: A total of 417,942 patients were included (mean age=69.0 years; 50.9% male). Regional differences were observed in race, income, insurance status, stage at diagnosis, and distance traveled for care. The proportion of Black patients ranged from 2.6% in the Mountain region to 19.9% in the Southeast. Low-income households were most common in the Southwest (82.0%) and least common in the Northeast (50.7%). Uninsured status was most frequent in the Southwest (5.3%). Stage IV disease was the most common presentation in all regions, affecting approximately half of all patients at diagnosis. Patients in the Mountain region traveled the greatest distance for treatment (mean, 62.7 miles), whereas those in the Northeast traveled the shortest distance (mean, 26.8 miles). Conclusion: These findings identify important regional differences in access to pancreatic cancer care and provide a national benchmark for future interventions aimed at improving equitable access to specialized care.