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SEER data show that pancreatic cancer mortality rates differ by ethnicity



African Americans have higher mortality rates from pancreatic cancer compared with whites and Asians/American Indians, results from a large population-based study showed.

Dr. Mohamed Gad, internal medicine resident at Cleveland Clinic Doug Brunk/MDedge News

Dr. Mohamed Gad

However, between 2013 and 2015, mortality rates began to fall among all ethnicities, for reasons that remain unclear. “There is still a significant disparity between the [white] and African American populations,” lead study author Mohamed M. Gad, MD, said at the annual Digestive Disease Week. “Trends for the Asian/American Indian populations were similar to that of the [white] population.”

While most patients diagnosed with pancreatic cancer are white men, the disparities among racial and ethnic groups have not been addressed on a large scale, said Dr. Gad, an internal medicine resident at the Cleveland Clinic. In an effort to investigate the racial disparities in mortality rates in patients with pancreatic cancer, he and colleagues collected data from the National Cancer Institute’s Surveillance, Epidemiology and End-Results Program (SEER) 9 database during 1973 to 2015. The researchers calculated mortality rates for all pancreatic cancer cases by race. Next, they calculated the Observed/Expected (O/E) ratio and the excess risk per 10,000 person-years to estimate the change of risk following the diagnosis in different ethnicities, when compared to the general population, using Joinpoint Regression software.

Dr. Gad reported results from 65,985 patients who died from pancreatic cancer between 1973 and 2015. The overall mortality rate was highest for African Americans (9.4%), followed by whites (6.4%), and Asians/American Indians (5.4%). The researchers observed that mortality rates of all racial groups continued to increase from 1973 until 2013. However, between 2013 and 2015, the mortality rates decreased by 20.5% for African Americans, by 27.1% for whites, and by 25.1% for Asians/American Indians (P less than .001 for all decreases). Socioeconomic status and access to health care have been hypothesized to play a role in these observed outcomes, Dr. Gad said, but more research is needed to understand the observed disparities and assess the need for intervention. For example, he said, one line of research would be to evaluate the difference between access to health care and the quality of health care delivery for African American patients compared with their white counterparts. “Once we identify that, how can we improve outcomes for the African American population?” Dr. Gad asked.

He reported having no financial disclosures.

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