Abstract B026: Exploring differences in supportive care medication use among racial and ethnic minorities with pancreatic and colorectal cancers
Authors: Allen John M. , Awunti MegCholack , Guo Yi , Rogers Sherise C. , Scarton Lisa , Whitner Chardaé , Wilkie Diana J. 
Published: December 2023

Background: Pancreatic (PC) and colorectal cancer (CRC) are both cancers of the digestive system, with similar symptom profiles. Neurologic and psychiatric symptoms are commonly seen in multiple types of cancer including PC and CRC. Supportive care medications (SCM) are central to symptom management and improving health-related Quality of Life (HRQoL). Examples of SCM used to manage these symptoms include opioid analgesics, non-opioid analgesics, antidepressants, anxiolytics, and antipsychotics. Racial disparities in clinical outcomes including HRQoL have been reported in PC and CRC, respectively.  While racial disparities have been separately described in the use of SCM for PC and CRC, no comparisons of SCM use based on cancer type in racial and ethnic minorities has been performed. The purpose of our study was to explore differences in SCM use among racial and ethnic minorities with PC and CRC, respectively.  Methods: We used the National Cancer Institute Surveillance Epidemiology and End Results (NCI SEER)- Medicare-linked database to analyze all patients with a PC or CRC diagnosis and a newly initiated outpatient prescription claim for an SCM of interest from 2009-2018. Patients on SCM before cancer diagnosis or were not a member of racial or ethnic group were excluded from the analysis. We assessed five SCM classes, including opioids, non-opioid analgesics, antidepressants, anxiolytics, and antipsychotics. Prescription claims were specific to patients diagnosed with PC or CRC, and compared by cancer type. Our objective was to characterize the relationship between cancer type and receipt of SCM in racial and ethnic minorities. Results: After assessment of our inclusion/exclusion criteria, 45,502 patients were included in the analysis (PC- 44.9%; CRC- 55.1%). Racial demographics were as follows: Black/African American: 51.5%, Hispanic- 23.6%, Asian- 23.5%, American Indian/Alaska Native: 1.3%. When comparing cancer types, patients with PC were more likely to receive multiple classes of SCM including opioids (Odds Ratio [OR] 2.17, 95%CI: 2.09-2.25), non-opioid analgesics (OR 1.29, 95%CI: 1.22-1.37), antidepressants (OR 1.19, 95%CI: 1.14-1.24), and anxiolytics (OR 1.45, 95%CI:1.37- 1.54). PC patients were less likely to receive antipsychotics (OR 0.77, 95%CI: 0.72- 0.83). Differences were similar when disaggregated by specific race and ethnicity.  Conclusion: Among racial and ethnic minorities, patients with PC were more likely to be prescribed multiple classes of SCM used to treat neurologic and psychiatric symptoms, including opioids, non-opioid analgesics, antidepressants, and anxiolytics. The observed results suggests a heavier overall symptom burden for PC in this population.

Citation Format: John M. Allen, MegCholack Awunti, Yi Guo, Sherise C. Rogers, Lisa Scarton, Chardaé Whitner, Diana J. Wilkie. Exploring differences in supportive care medication use among racial and ethnic minorities with pancreatic and colorectal cancers [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B026.