Abstract 6112: Uncovering clinicopathological factors contributing to racial inequities in pancreatic cancer in Hampton Roads, Virginia
Authors: Chaudhry Fatima W. , Kolkey Zakary L. , Hannah Ashleigh E. , Hoefer Richard A. , Tang Amy 
Published: March 2024

Abstract
Introduction: Pancreatic Ductal Adenocarcinoma (PDAC) is the 3rd leading cause of cancer-related deaths, with 12% surviving 5 years post-diagnosis. The delayed symptom onset, lack of effective screening, and advanced presentation render most patients ineligible for surgery. For inoperable PDAC, treatment offers only palliative support, resulting in a 1-year median survival, in contrast to 3 years for operable cases. Black patients face a 30-70% higher PDAC mortality rate than other racial groups in the United States. In Hampton Roads, Virginia, from 2015-2019, the black PDAC population had a mortality rate of 17.3%, notably surpassing the 10.8% rate among white PDAC patients. Consequently, this project aims to address the disparate disease burden of PDAC in the black Hampton Roads community.
Methods: Chart review of 427 inoperable PDAC patients from the Sentara Cancer Network and Virginia Oncology Associates was conducted. Age at diagnosis, treatment date, treatment type, and death date of the black and white inoperable cohorts were extracted. Average length of disease, age of onset, and time from diagnosis to treatment were calculated. KM survival analysis compared the cohorts’ survival rates.
Results: From 2008 to 2016, the white cohort had shorter survival rates than the black cohort. The black population averaged a disease length of 249 days, while the white population faced 190 days. The average age at diagnosis was 67 in the black cohort and 70 in the white cohort. 42.1% of white PDAC patients did not receive treatment, while 29.9% of black PDAC patients went untreated.
Discussion: While the black population faces higher mortality, the white PDAC inoperable cohort had shorter disease duration and lower survival. A higher number of white patients also did not receive therapy, likely due to their older age, leading to added comorbidities and advanced stages of disease. Elder patients often decline treatment due to its limited impact on lifespan and quality of life. Further, the longer survival found in black patients may paradoxically contribute to a high mortality rate in Black patients. 21% of the black cohort survived over a year, prompting questions about their classification as inoperable and their access to the only curative treatment. This discovery motivates examination of the decisions behind labeling these patients as inoperable. The ongoing investigation into factors, such as stage at diagnosis and standard of care adherence, strives to continue to uncover the reasons for the high mortality rate in the Black PDAC Hampton Roads population.
Citation Format: Fatima W. Chaudhry, Zakary L. Kolkey, Ashleigh E. Hannah, Richard A. Hoefer, Amy Tang. Uncovering clinicopathological factors contributing to racial inequities in pancreatic cancer in Hampton Roads, Virginia [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 6112.