Early-Onset Pancreatic Cancer Increased in White and Hispanic Women

pancreatic cancer
pancreatic cancer
Researchers examined trends of early- and late-onset pancreatic cancer across different sex and racial and ethnic groups in the US.

Between 1995 and 2018, non-Hispanic White and Hispanic women in the United States experienced the greatest increases in early-onset pancreatic cancer (EOPC) incidence, according to study results published in Gastroenterology.

Researchers extracted data from the North American Association of Central Cancer Registries (NAACCR) for the years 1995 to 2018. The NAACCR dataset consists of information from all US-based cancer registries, including patient demographics and medical history. The present analysis categorized all cases of invasive pancreatic cancer as either EOPC or late-onset pancreatic cancer (LOPC) based on a cut-off age of 55 years. Annual age-adjusted incidence rates for both EOPC and LOPC were calculated for the entire cohort, then for each sex- and race-based strata. Annual percent change in age-adjusted incidence rates were also estimated.

Between 1995 and 2018, a total of 713,622 incident cases of invasive pancreatic cancer were recorded in US registries, of which 80,908 were early-onset and 632,714 were late-onset. Within this cohort, the largest racial and ethnic group was White (77.7%), followed by non-Hispanic Black (11.9%), Hispanic (6.8%), and non-Hispanic Asian/Pacific Islander (2.8%). Compared with LOPC, patients with EOPC were more often men, less often non-Hispanic White, and were more likely to have advanced stage cancer at diagnosis. The incidence rates for both EOPC and LOPC increased steadily over the study period, though the average annual percent increase was greater for LOPC (+0.84%; 95% CI, 0.78%-0.90%) compared with EOPC (+0.40%; 95% CI, 0.24%-0.57%).

For EOPC, the greatest annual percent increases were observed in non-Hispanic White patients (+0.58%; 95% CI, 0.41%-0.75%) and Hispanic patients (+0.46%; 95% CI, 0.13%-0.79%). Non-Hispanic Black patients experienced an overall decrease in annual EOPC incidence rates (-0.23%; 95% CI, -0.45% to 0.00%). However, despite this decreasing trend, non-Hispanic Black patients had higher base incidence rates of EOPC than other race and ethnicity groups.

Incidence rates were higher for men compared with women for both EOPC and LOPC. However, only women had a significant increasing annual trend for EOPC cases (+0.77%; 95% CI, 0.56%-0.98%), while men had a nonsignificant increasing trend. This trend was driven largely by substantial annual increases among non-Hispanic White women (+0.99%; 95% CI, 0.73%-1.25%) and Hispanic women (+0.68; 95% CI, 0.17%-1.20%). Among men, non-Hispanic Black patients had a significant decreasing EOPC incidence trend (-0.66% annually; 95% CI, -0.93% to -0.38%), while non-Hispanic White patients had a significant increasing trend (+0.28% annually; 95% CI, 0.09%-0.47%). For LOPC, both men and women experienced significant increases in incidence rates, with the increases largely driven by rising numbers among non-Hispanic White patients.

Results from this study outline the incidence rates of pancreatic cancers in the US, which have increased significantly since 1995. Regarding study limitations, researchers noted that data on certain cancer risk factors were not available, such as smoking.

“The more rapid increases in EOPC incidence for non-Hispanic White and Hispanic [women] indicate that these higher-risk populations might benefit from targeted surveillance and interventions,” the study authors wrote. “Future studies should seek to elucidate whether these differences across race [and] ethnicity are attributable to specific tumor characteristics, biomarkers, or other sociodemographic factors.”

Reference

Huang BZ, Liu L, Zhang J, et al. Rising incidence and racial disparities of early-onset pancreatic cancer in the United States, 1995-2018. Gastroenterology. Published online March 11, 2022. doi:10.1053/j.gastro.2022.03.011