Abstract C091: Racial disparities in pancreatic cancer pancreatic cancer patients in Florida and an investigation into a possible role of cancer cachexia
Authors: Underwood Patrick , Cameron Miles , Daly Ashley Clark , Barnett Tracey , Gwede Clement , Magliocco Anthony , Centeno Barbara , Chen Dung-Tsa , Choi Jung , Jeong Daniel , Gillies Robert , Malafa Mokenge , Judge Andrew , Merchant Nipun , Permuth Jennifer , Trevino Jose 
Published: August 2020

Abstract
Background: Five-year survival for pancreatic cancer remains low at 8%. While pancreatic cancer health disparities exist among different racial groups, these disparities have not been well investigated in the State of Florida. We aimed to investigate these disparities and hypothesized that cancer cachexia may play a role.
Methods: A retrospective review of data from the Florida Cancer Data System and Florida Agency for Healthcare administration was performed to assess for PC disparities between racial groups in the State of Florida. A cohort of patients at a single center was analyzed for differences in cachexia indicators such as psoas muscle index (PSI) and albumin at presentation.
Results: African Americans (AA) had significantly higher mean age-adjusted PC incidence (12.5/100,000) and mortality rates (10.97/100,000) than NHW (incidence=11.2/100,000; mortality=10.3/100,000) and Hispanics (incidence=9.6/100,000; mortality=8.7/100,000). Of the 67 counties in the State of Florida, 43 (64.2%) observed higher PC incidence rates in AA than NHW and Hispanics. AA are often diagnosed with PC at a younger age than NHW. AA and Hispanics are more likely to be insured by Medicaid compared to NHW (16% and 14% vs 7%, respectively) and less likely to undergo surgical treatment for their condition (31% vs. 37%). AA present with significantly lower serum albumin levels (3.2 vs. 3.7 g/dL). Serum albumin levels &lt; 3.5 correlated with significantly lower survival. When compared to healthy controls presenting for cholecystectomy, AA patients present with a more significant reduction in psoas muscle index compared to Caucasians.
Conclusion: African-Americans with PC have higher incidence rates and mortality than their NHW and Hispanics counterparts. AA are also younger at age of diagnosis, more likely to be insured by Medicaid, and less likely to undergo potential curative surgical treatment for PC. We demonstrated that AA had significantly lower albumin levels and that this correlated with worse survival. AA also present with a significantly greater reduction in psoas muscle index when compared to healthy controls. Further investigation into potential reasons for this disparity in cancer cachexia is warranted.
Citation Format: Patrick Underwood, Miles Cameron, Ashley Clark Daly, Tracey Barnett, Clement Gwede, Anthony Magliocco, Barbara Centeno, Dung-Tsa Chen, Jung Choi, Daniel Jeong, Robert Gillies, Mokenge Malafa, Andrew Judge, Nipun Merchant, Jennifer Permuth, Jose Trevino. Racial disparities in pancreatic cancer pancreatic cancer patients in Florida and an investigation into a possible role of cancer cachexia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C091.