Abstract 4245: Racial disparities in comorbidities, income levels, and surgical procedures observed in hispanic patients with pancreatic cancer compared to non-hispanic patients results from the national inpatient sample database
Authors: Peña Miren , Kintada Jswanth Raj , Hegde Sheetal , Rouhani Sammira , Munoz Edgar , Michalek Joel , Seifi Ali , Ramirez Amelie , Kumar Pratap A. , Shah Dimpy 
Published: August 2018

Background: Higher incidence and lower survival rates have been linked to racial/ethnic and socioeconomic (SES) disparities in patients with pancreatic cancer. However, systematic evaluation of the interaction between race/ethnicity, SES, comorbidities and type of surgical procedures to predict outcomes associated with pancreatic cancer are missing. Hence, we conducted this study to investigate these risk factors and outcomes of pancreatic cancer discharges, with a focus on Hispanic population.

Methods: We surveyed Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database for year 2014 to identify patients with pancreatic cancer (ICD9: 230.9, 157.1-157.4, 157.8, 157.9). To identify racial disparities, we examined age, median household income at zipcode level, various comorbidities (e.g. alcohol abuse, diabetes, obesity, liver disease, hypertension, chronic pulmonary disease, etc.), types of surgical treatments (surgical vs non-surgical options; Whipple vs. others) as a treatment choice, and death during hospitalization.

Results: From approximately 7 million records, we identified 18,069 pancreatic cancer-related discharges. The median age of patients was 68 years (range: 0 to 90 years). Compared to NHW, Hispanics had a significantly higher prevalence of diabetes (40% vs. 30%, p&lt;0.001) and liver disease (8% vs. 5%, p&lt;0.001), whereas no significant differences were observed for obesity, hypertension, congestive heart failure, or alcohol abuse. Majority of Hispanic patients (39%) with pancreatic cancer belonged to lowest income quartile ($1 - $39,999 per year) compared to NHW (20%), P value &lt;0.001. The only two factors associated with the difference in receiving Whipple procedure were having underlying liver disease and the income level, stratified by race/ethnicity. We did not identify any factors associated with differences in mortality rates.

Conclusions: We identified significant racial disparities such as higher prevalence of comorbidities, lower income levels, and different types of surgical procedures in Hispanic versus NHW patients hospitalized for pancreatic cancer. Future studies quantifying the impact of stage of illness at presentation, multiple comorbidities including smoking, rural/urban care setting, SES, insurance coverage on treatment choices and outcomes associated with pancreatic cancer in different racial/ethnic groups are needed.

Citation Format: Miren Peña, Jswanth Raj Kintada, Sheetal Hegde, Sammira Rouhani, Edgar Munoz, Joel Michalek, Ali Seifi, Amelie Ramirez, Pratap A. Kumar, Dimpy Shah. Racial disparities in comorbidities, income levels, and surgical procedures observed in hispanic patients with pancreatic cancer compared to non-hispanic patients results from the national inpatient sample database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4245.