BACKGROUND: @entity788 accounts for approximately 7% of all @entity5 deaths. More than half of all @entity788 are stage IV at diagnosis, where systemic chemotherapy is used with the goal of life prolongation as well as palliation. The @entity1 characteristics and health system factors that drive the use of systemic therapy are unknown. METHOD: This is a retrospective study of stage IV @entity788 @entity1 (n = 140,210) diagnosed between 2000 and 2011 in the NCDB. NCDB contains approximately 70% of new @entity5 diagnosis from more than 1500 accredited @entity5 programs in the United States and Puerto Rico. Chi-squared test was used to determine any differences in characteristics of @entity1 who did or did not receive systemic therapy. RESULTS: Our study demonstrated that only 49.1% of stage IV @entity788 @entity1 received systemic therapy. The use of systemic therapy is significantly lower in female, African American/Hispanic, @entity1 older than 40 years, those without insurance or with Medicare and Medicaid, higher Charlson Comorbidity Score, poor economic and educational status and in nonacademic centers. CONCLUSIONS: This is the largest study to evaluate the determinants of systemic therapy use in stage IV @entity788 . The use of systemic therapy was significantly lower in @entity1 older than 40 years, lower educational status, nonprivate insurance and with higher Charlson Comorbidity Scores. In addition, the use of systemic therapy was lower with female sex, African Americans/Hispanic, and lower socio-economic status. Understanding the barriers in the use of systemic therapy as well as appropriate utilization of systemic therapy can both optimize @entity5 care.

Systemic therapy in stage IV XXXX : a population-based analysis using the National Cancer Data Base.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity788 :: ('MESH:D010190', 'Disease') :: ['Pancreatic cancer', 'pancreatic cancer', 'pancreatic cancers']
@entity788 :: (MESH:D010190,Disease) :: ['pancreatic cancer']
