Sociodemographic Factors that Influence Access to Care in Patients with Gallbladder Cancer: A National Cancer Database (NCDB) Analysis.

Chemotherapy in advanced stage gallbladder cancer (GBC) has been shown to improve overall survival; however, chemotherapy for early-stage GBC is still being evaluated. As clinical studies determine the most effective treatment for GBC, sociodemographic factors should be evaluated to identify limiting factors in obtaining treatment. The objective of this study was to identify these factors in patients with GBC. Retrospective analysis of the National Cancer Database (NCDB) from 2010-2022 was performed to identify sociodemographic factors that influenced treatment, defined as no intervention, surgery, or surgery with chemotherapy, in patients with stage II and III GBC. Cox regression analysis was performed to determine factors that influenced survival. For stage II GBC, age (p<0.001), ethnicity (p=0.019), insurance (p<0.001), and distance travelled to a hospital (p<0.001) were statistically significant factors in the treatment patients received. In patients with stage III GBC, age (p<0.001), facility (p=0.041), education (p=0.001), income (p=0.002), insurance (p<0.001), and Charlson-Deyo score (p<0.001) were significant in treatment received. Cox analysis revealed for stage II GBC, treatment (p=0.050), age (p<0.001), race (p=0.028), income (p=0.005), insurance type (p=0.021), and Charlson-Deyo score (p<0.001) were significantly influenced survival, whereas for stage III GBC, treatment (p<0.001), race (p<0.001), and ethnicity (p<0.001) were significant. While there are certain sociodemographic factors that are nonmodifiable, modifiable factors, such as insurance and access to facilities, should be addressed to provide patients with opportunities to obtain appropriate care. By ensuring access to healthcare, survival rates may be improved in patients with stage II and III GBC.