Abstract A076: Pancreatic cancer survival disparities in Florida using a statewide database

Abstract

Introduction Pancreatic cancer (PC) portends a poor prognosis, is the current third-leading cause of cancer deaths in the United States, and is still rising. The state of Florida has the second-highest rate of new cases of PC within the United States with an incidence of 460/100,000. It is also a disease with significant disparities. African Americans with PC have a 50–90% increased incidence, lower rates of surgery, and worse overall mortality in comparison to other racial groups. With increased knowledge of these disparities in recent years, we sought out to identify whether these differences were present in the state of Florida by examining differences in pancreatic cancer survival outcomes between race, age, and income. Materials and Methods Patients with pancreatic adenocarcinoma diagnosed from January 1st, 2017 to October 31st, 2020 were identified through the statewide clinical research and network database called OneFlorida Clinical Consortium (OneFlorida) by using the ICD10 diagnosis code for pancreatic cancer. Patients with a diagnosis of neuroendocrine carcinoma were excluded. Patients were followed for at least one year unless a death occurred. Summary statistics were reported for demographic variables. The demographic variable for income was stratified by low being < $53,000 and high being ≥ $53,000. Kaplan-Meier analysis with log-rank test was performed to compare the difference in overall survival time among groups. Cox proportional hazards models were also fitted to test the between-group differences and compute the 95% confidence intervals of hazard ratio, while adjusting for informative covariate(s) when necessary. Results A total of 2,739 unique patients were available for analysis. The distribution of the sample was 68.7% White, 23.4% Black, and 7.9% Other. The median age was 67 years (27–89). There were 49.8% women and 50.2% men. The median income was $52,915 ($23,704–$124,821). Significant differences in overall survival were detected (p-values < 0.001) between age, income, and racial groups, but not between sex. Patients that were Black, >67 years old, and had low-income had a significantly less survival time than their corresponding contrasts independently. The mean survival (in days) for low income vs. high income was 779.5 vs. 945.9 (p<.0001). The differences remained significant in stratified analyses by cancer stage. In stage II PC, the mean survival (in days) for White vs. Black populations was 1134.9 days vs 472.2 days, and in stage IV PC the survival comparison was 770.2 days vs. 787.5 days between the same groups. Discussion Significant race, age and income disparities in survival exist in the state of Florida. These disparities are present even when stage is accounted for. Knowledge of health disparities statistics are not sufficient, and a targeted multi-stakeholder approach needs to be developed to improve survival outcomes of our patients. Limitations to this study include the racial demographic of “other” not having further description due to limited data availability through the clinical research network. Citation Format: Guettchina Telisnor, Alexander S. Lim, Zhongyue Zhang, XiangYang Lou, Ibrahim Nassour, Sherise C. Rogers. Pancreatic cancer survival disparities in Florida using a statewide database [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A076.