Abstract 1018: Characteristics and outcomes of patients with cystic fibrosis and pancreatic cancer: A population-based comparative analysis
Authors: Manchkanti Srija , Gaddam Shiva J. , Grewal Udhayvir S. 
Published: March 2024

Introduction: Advancements in diagnosis and treatment of cystic fibrosis (CF) has allowed improvement in overall survival which also in part explains the increasing incidence of malignancies among these patients, particularly, gastrointestinal cancers. Existing data related to the characteristics and outcomes of patients with CF and pancreatic cancer (PC) are limited to small case series. We sought to investigate the same using a large population-based database.

Methods: We used TriNetX, a national database comprising approximately 74 million patients across 54 healthcare organizations in the United States. We retrospectively identified patients with CF who also had a diagnosis of PC (using ICD-10 codes). We then performed an age, sex and race-matched analysis to compare patients with CF+PC to patients with CF alone. To study the impact of CF diagnosis on PC-related outcomes, we performed a propensity matched analysis between cohorts of patients with CF+PC and patients with PC alone. Kaplan Meier estimates were used for survival analysis. A p-value of &lt;0.05 was considered statistically significant.

Results: We identified a total of 41,655 patients with CF, out of which 198 patients had a diagnosis of PC (0.48 %). A total of 180 patients were included in the propensity matched comparative analysis. Patients with CF and PC had a significantly higher prevalence of type 2 diabetes mellitus (42.8% vs 5.6%, p&lt;0.001), hypertension (58.3% vs 5.6%, p&lt;0.001) and hyperlipidemia (40% vs 5.6%, p&lt;0.001) than patients with CF with no PC. No differences in the prevalence of liver cirrhosis were noted (8.9% vs 5.6%, p=0.22). Patients with PC and CF had a significantly lower prevalence of bronchiectasis (15.8% vs 28.7%, p=0.004). In a propensity matched analysis between patients with CF and PC and PC alone, CF did not impact survival among patients with resectable [HR=1.042 (0.35-3.11), p=0.79] or unresectable/advanced PC [HR=1.17 (0.62-2.22), p=0.09].

Conclusion: To our knowledge, this is the largest analysis investigating the characteristics and outcomes of patients with CF and PC. The prevalence of PC in patients with CF is higher than reported prevalence among general population. We found a significantly higher prevalence of diabetes, hypertension and hyperlipidemia and a significantly lower prevalence of bronchiectasis among patients with CF and PC. CF does not appear to impact overall survival among patients with resectable or unresectable or advanced PC. Our findings may inform risk prediction models for PC among patients with CF.

Citation Format: Srija Manchkanti, Shiva J. Gaddam, Udhayvir S. Grewal. Characteristics and outcomes of patients with cystic fibrosis and pancreatic cancer: A population-based comparative analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1018.