Risk of pancreatic adenocarcinoma

Disparity between African Americans and other race/ethnic groups

Authors

  • Kenneth J. Chang M.D.,

    Corresponding author
    1. Division of Gastroenterology, Department of Medicine, University of California, Irvine Medical Center, Orange, California
    • Comprehensive Digestive Disease Center, Department of Gastrointestinal Oncology, University of California, Irvine Medical Center, 101 The City Drive, Building 22C, First Floor, Room 106, Orange, CA 92868-3298
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    • Fax: (714) 456-8009

  • Gulshan Parasher M.D.,

    1. Division of Gastroenterology, Department of Medicine, University of California, Irvine Medical Center, Orange, California
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  • Catherine Christie M.S.,

    1. Division of Epidemiology, Department of Medicine, University of California, Irvine, Irvine, California
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  • Joan Largent Ph.D.,

    1. Division of Epidemiology, Department of Medicine, University of California, Irvine, Irvine, California
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  • Hoda Anton-Culver Ph.D.

    1. Division of Epidemiology, Department of Medicine, University of California, Irvine, Irvine, California
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Abstract

BACKGROUND

African Americans have a higher incidence of pancreatic adenocarcinoma compared with non-Hispanic whites. Whether other clinical differences exist between these two groups is not well known.

METHODS

The authors conducted a population-based retrospective analysis of all patients with pancreatic adenocarcinoma in both a regional and a statewide database between 1988 and 1998. Their goal was to evaluate differences in incidence rates, clinical presentation, including age at diagnosis, gender, and tumor characteristics, and treatment among race/ethnic groups.

RESULTS

African Americans had a higher age-adjusted incidence rate of pancreatic adenocarcinoma (8.78) compared with non-Hispanic whites (5.89), Hispanics (5.09), Asians (4.75), and all race/ethnicities combined (5.82). African Americans also presented at a later stage of disease and received less surgery than all other race/ethnicities, despite equal availability of medical insurance. The analyses also revealed gender differences. In general, males maintained a higher incidence rate of pancreatic adenocarcinoma than females across all race/ethnicities. In all race/ethnic groups, females were diagnosed at an older age and an earlier stage of disease than males. The proportional hazard mortality ratio for females age < 60 was significantly less than that for males in the same age group (P < 0.02), even after accounting for stage and treatment.

CONCLUSIONS

African Americans in California had a higher incidence rate of pancreatic adenocarcinoma, had a slightly higher risk of presenting with advanced-stage diseas and with nonresectable tumors (i.e., tumors located in the body or tail of the pancreas), and underwent less surgical treatment than all other race/ethnicities. Younger females in all race/ethnic groups had a survival advantage over males of the same age. Cancer 2005. © 2004 American Cancer Society.

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