Introduction: Pancreatic cancer (PC) is the third-leading cause of cancer related-deaths in the US as of 2020. In recent years, there has been an increasing focus on the disparities of PC incidence. African Americans have worse overall outcomes compared to other racial groups. The stage of PC at time of diagnosis may be utilized to address this disparity.
Methods: This study analyzed the stage of PC at diagnosis in males by race/ethnicity from 2015-2019 using data extracted from the National Cancer Institute Surveillance, Epidemiology, and End Results Cancer (SEER) Statistics Explorer Network. Age-adjusted incidence rates per 100,000 are categorized into localized, regional, and distant stages of cancer diagnosis and stratified by race/ethnicity.
Results: For female patients, the rate of diagnosis was significantly higher for African Americans (AA) compared to other races across all stages of PC. AA females had higher incidence rates of localized, regional, and distant disease at 2.29%, 4.11%, and 6.96%, respectively [Table 1, Figures 1a]. In comparison, Asian/Pacific Islander (API) females had the lowest incidence rate at 1.34%, 2.78%, and 4.15%, respectively. The incidence rate per 100,000 for localized and regional PC was not significantly different between AA and Caucasian (CN) males at 2.10 and 2.18, respectively, for localized PC, at 4.44 and 4.45, respectively for regional PC [Figure1b]. Hispanic (HP) and API males had significantly lower incidence compared to AA and CN males at 1.76 and 1.58, respectively, for localized disease, and 3.13 and 3.17, respectively, for regional. Distant PC at time of diagnosis was significantly greater among AA males at 9.23%, compared to rates of 7.59% in CN males, 6.36% in HP males, and 5.11% in API males. All results p< 0.01.
Discussion: The rate of incidence for AA females is greater across all stages of PC, suggesting a genetic or socioeconomic predisposition, although further investigation is necessary. In males with PC, there is a disproportionately greater incidence of stage IV PC. With well-established increased mortality rates among AA, it is important to consider the role of access to healthcare. While multifactorial in etiology, highlighting the racial disparity in stage of PC at diagnosis emphasizes the importance of clinical suspicion. Earlier recognition should be prioritized with interventions to improve outcomes of PC in AA males.
