Seongmin Kim, MD
Cheongju-si, Ch'ungch'ong-bukto, Republic of Korea
Seongmin Kim, MD1, Hyeonwoo Kwon, MD1, Jun Su Lee, MD2, Jongwook Choi2, Byungha Cho2, Seon Mee Park, MD1
1Chungbuk National University Hospital, Cheongju-si, Ch'ungch'ong-bukto, Republic of Korea; 2Chungbuk National University Hospital, Cheongju, Ch'ungch'ong-bukto, Republic of Korea
Introduction: This study aimed to evaluate the disparity of diagnosis, treatment and prognosis of bile duct cancer (BDC) by the presence, severity and type of disability
Methods: Patients diagnosed with BDC were selected from a cohort, consisted with 1:3 ratio of age- and sex-matched population with or without disability from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. We evaluated the demographics, socioeconomic status, stages, treatment, and survival rates of BDC patients depending on the presence, severity and type of disability.
Results: The cohort included 15,065 patients with BDC, with a significantly lower rate among people with severe disabilities than people without or with mild disabilities (110.6 vs. 136.5 or 147.6 per 105 persons, respectively). Patients with disabilities had higher Charlson comorbidity index (1.43 vs. 2.00) and more below poverty line (6.0% vs. 11.9%) than those without disabilities. People with severe disabilities were diagnosed BDC at earlier age, but less likely to undergo surgery (adjusted odds ratio 0.52, 95% confidence interval 0.45-0.61) or chemotherapy (0.55, 0.45-0.67) than those without disabilities. This trend was more evident in patients with mental disorders. The overall and cancer specific mortality rates were higher in patients with disabilities than those without disabilities.
Discussion: In Korea, people with disabilities have a lower rate of BDC diagnosis, receive less surgery or chemotherapy, and have a lower survival rate than people without disabilities. This trend was more evident in patient with severe disabilities and with mental disorders.
Citation: Seongmin Kim, MD; Hyeonwoo Kwon, MD; Jun Su Lee, MD; Jongwook Choi; Byungha Cho; Seon Mee Park, MD. P0915 - DISPARITIES IN THE DIAGNOSIS AND TREATMENT OF BILE DUCT CANCER AMONG PEOPLE WITH DISABILITY: A NATIONAL COHORT STUDY IN THE REPUBLIC OF KOREA. Program No. P0915. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.