Presentations

Abstract

Introduction:

Pancreatic cancer is one of the most lethal diseases, with a dismal five-year survival rate of 9% and a median post-diagnosis survival of 6 months. It is currently the third leading cause of cancer-related death in the United States. The dismal prognosis of patients diagnosed with pancreatic cancer points to our limited arsenal of effective anticancer therapies and screening tools. Pancreatic cancer disproportionately affects the Black and Jewish populations; nationally we see lower survival and later stage at diagnosis among the black population when compared to their white counterparts.

Objectives:

This study aims to measure racial disparity in overall survival, diagnosis, and treatment regimens of pancreatic cancer in Hampton Roads Virginia in comparison to the national average. We hope to highlight the similarities/differences of cancer disparity in the two major racial groups in our local Pancreatic Ductal Adenocarcinoma (PDAC) cohort.

Methods:

This retrospective study uses a cohort of 640 patients diagnosed with pancreatic cancer between 2008 and 2016 within the Sentara Healthcare and/or Virginia Oncology Associates (VOA) system in Hampton Roads. The cohort was stratified into two groups: 191 patients diagnosed with operable disease who underwent surgical resection, and 449 patients diagnosed with inoperable disease; and then further separated into a white and black populations. Survival was calculated from date of initial diagnosis to date of last follow-up or death from all- cause mortality. Clinical and pathological parameters (TNM classification) and standard treatment modalities were reviewed, validated, and compared using electronic medical records at Sentara EPIC and VOA iKnow Medicine.

Results:

Of the 191 pancreatic cancer patients, 45 underwent surgical resection only, 100 received surgery and adjuvant chemotherapy, and 46 received NACT and surgery. In the operable cohort, 41.5% of the PDAC patients are African American (AA) and 55.8% are Caucasians. Thus, pancreatic cancer incidence among black patients was over-represented in Hampton Roads Virginia that has a 31.3% AA population. Treatment provided and stage of diagnosis for pancreatic cancer are comparable in the two major race groups. The total length of survival of our black patients was not worse when compared to the white patients in both operable and inoperable cohorts, however white patients more frequently met the 5-year survival milestone.

Conclusion:

Our PDAC patients of the two race groups still have a lower 5-year survival as compared to that of the national average (SEER data). The underlying factors contributing to the dismal 5-year survival rate and higher incidence are likely multifactorial, possibly explained by unhealthy diet, genetic factors, mutant carriers, social economic status, insurance, and increased risk behaviors as compared to national averages.