{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T18:47:39Z","timestamp":1773600459340,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early\u2010onset pancreatic cancer (EOPC), defined as pancreatic ductal adenocarcinoma (PDAC) diagnosed at or before age 50, is an increasingly recognized clinical entity with a rising incidence. Despite advancements in treatment, socioeconomic status (SES) disparities have impacted access to care and survival. This study examined the relationship between SES and survival in EOPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the National Cancer Database (2004\u20132022) were analyzed for patients diagnosed with EOPC. SES was determined using a composite measure incorporating education and income levels and was categorized into four quartiles. Kaplan\u2010Meier survival analysis and multivariable Cox proportional hazards modeling were used to assess survival differences across the SES groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10,729 patients with EOPC were included, with 24.0% in the low SES group, 29.9% in mid\u2010low SES, 30.3% in mid\u2010high SES, and 15.8% in high SES. Higher SES was associated with increased access to multimodal therapy, including neoadjuvant and adjuvant chemotherapy, radiation, and surgical resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Private insurance coverage was significantly higher in the high\u2010SES group (81.1% vs. 50.2% in the low\u2010SES group,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariable Cox regression showed that patients in the high\u2010SES group had a significantly lower risk of mortality (HR\u2009=\u20090.71, 95% CI: 0.54\u20130.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033). The median survival increased from 9 months in the low SES group to 12 months in the high SES group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Kaplan\u2010Meier analysis showed that survival differences by SES were most pronounced in advanced\u2010stage disease, particularly in stage III (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) and stage IV (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) cancers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lower SES was consistently linked to worse EOPC survival, particularly in advanced stages. Addressing SES\u2010related disparities through targeted interventions and healthcare policy reforms could improve outcomes across all disease stages. Further research into the unique tumor biology and molecular characteristics of EOPC is needed to better understand how SES influences disease progression and treatment response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70148","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:08:31Z","timestamp":1766498911000},"page":"349-360","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survival Disparities in Early\u2010Onset Pancreatic Cancer (EOPC): The Role of Socioeconomic Status and Healthcare Access"],"prefix":"10.1002","volume":"133","author":[{"given":"Abdullah","family":"Khalid","sequence":"first","affiliation":[{"name":"Northwell Health, North Shore\/Long Island Jewish General Surgery Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Anjum","family":"Fazal","sequence":"additional","affiliation":[{"name":"Aga Khan University Karachi Sindh Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manav","family":"Shah","sequence":"additional","affiliation":[{"name":"Northwell Health, North Shore\/Long Island Jewish General Surgery Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"DePeralta","sequence":"additional","affiliation":[{"name":"Northwell Health, North Shore\/Long Island Jewish General Surgery Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepideh","family":"Gholami","sequence":"additional","affiliation":[{"name":"Northwell Health, North Shore\/Long Island Jewish General Surgery Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliot","family":"Newman","sequence":"additional","affiliation":[{"name":"Northwell Health Lenox Hill Hospital New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcovalerio","family":"Melis","sequence":"additional","affiliation":[{"name":"Northwell Health Lenox Hill Hospital New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Northwell Health, North Shore\/Long Island Jewish General Surgery Manhasset New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v12.i2.173"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-018-0866-z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.28242"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2023.41.16_suppl.4018"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2015.4239"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071498"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","unstructured":"F.Zhu H.Wang andH.Ashamalla \u201cRacial and Socioeconomic Disparities in the Treatments and Outcomes of Pancreatic Cancer Among Different Treatment Facility Types \u201dPancreas. 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