Published Research

An Analysis of the National Cancer Database

In a study comparing over 250,000 pancreatic cancer patients from the National Cancer Database, Gallegos et al. (2023) found significant associations between race, sex, insurance status, education, income, and geographic location with the stage of disease at diagnosis. Their analysis found that males were more likely to be diagnosed with late-stage cancer, Black patients presented at a later stage than white patients, and uninsured patients also had a later stage diagnosis compared to patients with insurance. Furthermore, when looking at location, the researchers learned that patients from a zip code with less than $38,000 median household income and those from a zip code with lower levels of education had higher rates of late-stage diagnosis as well. Most significantly, patients who were African American, Hispanic, or uninsured had much higher rates of a late-stage diagnosis. These results support the current extensive research that systemic discriminations perpetuate worse survival outcomes in these underserved populations. Healthcare institutions and providers need to acknowledge these inequalities and work towards creating the resources and opportunities necessary to provide adequate care.

 

American Cancer Society

The American Cancer Society recently released their Cancer Fact & Figures 2023 report. Between 2022 and 2023 the estimated number of new pancreatic cancer cases has risen by 1,840 from 62,210 to 64,050. Since the late 1990s, the incidence rate for pancreatic cancer has increased by about 1% each year. As a result, the estimated number of people who will die from the disease has risen from 49,830 to 50,550, an increase of 720 (ACS, 2023). However, the death rate for pancreatic cancer has been slowly deceasing. As of 2023, the five-year survival rate has increased to 12% compared to 11% in 2022. According to Dr. Rosario Ligresti, chief of gastroenterology at Hackensack University Medical Center, this is the first time since 2017 that the survival rate has gone up two years in a row (Ligresti, 2023).

 

Germline testing

Germline genetic testing is important for individuals diagnosed with pancreatic cancer or who may be at high-risk for developing the disease. Undergoing germline testing can help in determining treatment options for patients with pancreatic cancer, can provide information about one’s likelihood of developing the cancer, and can inform whether their family members are at risk, according to the Pancreatic Cancer Action Network. A recent study found that underserved patients were more likely to experience delays in testing. Most significantly, there was a much longer delay in getting germline testing done among African Americans. Furthermore, the researchers found that lower socioeconomic classes and social work needs were also associated with testing delays. The researchers found that patients who obtained pre-diagnostic testing were Asian or white (Scott, 2023). Healthcare professionals can help reduce these disparities by bringing awareness to the issue. Physicians should promote germline testing for high-risk individuals and patients diagnosed with pancreatic cancer. More research needs to be done to understand the factors that contribute to disparities in germline testing and to find solutions to reduce these gaps.​

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The Multicenter Cancer of Pancreas Screening-5 study 

Dbouk et al. observed and reported how the screening of individuals at high-risk of developing                    pancreatic cancer within the Multicenter Cancer of Pancreas Screening-5 study impacted stage at              diagnosis and survival. The study showed that screening those at high-risk can help detect                            precancerous conditions and cancers early when they are most treatable (Dbouk, 2022). Most of the            patients with pancreatic ductal adenocarcinoma (PDAC) diagnosed in the multicenter CAPS5 study             had stage I disease. Furthermore, according to the authors, the five-year survival rate for patients with “screen-detected PDAC was 73.3%, and median overall survival was 9.8, compared with 1.5 years for patients diagnosed with PDAC outside of surveillance” (Dbouk, 2022). As of 2023, the five-year survival rate for patients with pancreatic cancer is 12% (ACS, 2023). Therefore, the CAPS5 study results were quite impressive and should be further studied. This study emphasizes the importance of screening individuals at high-risk of developing pancreatic cancer, and the potentially dramatic impact it may have on mortality rates.

 

Surveillance program at Hackensack University Medical Center 

Hackensack University Medical Center in Hackensack, New Jersey, is conducting a surveillance program for individuals who are at high-risk for developing familial or hereditary pancreatic cancer. The researchers are using the first blood test on the market dedicated to the early detection of familial or hereditary pancreatic ductal adenocarcinoma (PDAC) (Hackensack Meridian Health). Pancreatic cancer screening is critical for high-risk groups including those with the BRCA mutation, cystic fibrosis, familial adenomatous polyposis, familial atypical multiple mole melanoma, hereditary nonpolyposis colorectal cancer or Lynch Syndrome, hereditary pancreatitis, PALB2 mutation, Peutz-Jeghers syndrome, or family history of pancreas cancer in two first-degree relatives (Hackensack Meridian Health). Healthcare workers in the program provide patients and their loved ones with personalized information, resources, and treatment options.

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More:

• A meta-analysis by Cervantes, Waymouth and Petrov found 40% higher rates of pancreatic cancer among African Americans compared to white Americans.

• In a study by Heller, Nicolson, and Ahuja, compared to white pancreatic cancer patients, African American patients had a significantly younger mean age, more often presented at ages younger than 65, had more advanced disease (stage III or IV) at diagnosis, and had a higher burden of comorbid disease.

• Abraham and colleagues found that when African American patients were just as likely as white patients to show resectable disease, they were 34% less likely to receive surgery, 30% less likely to receive adjuvant chemotherapy, and 50% less likely to receive primary chemotherapy.

• Murphy and colleagues found that African American pancreatic cancer patients were significantly less likely than white patients to see a medical oncologist (52.6% vs. 60.2%), radiation oncologist (25.6% vs 32.5%), or a surgeon (72% vs. 78%).