e16356 Background: Pancreatic cancer (PC) is a leading cause of cancer-related deaths, with a 5-year relative survival rate of roughly 13%. Significantly, the incidence of PC is increasing among patients younger than 50 years, referred to as early-onset pancreatic cancer (EOPC). However, literature is sparse with regards to the demographic, socioeconomic, and clinical differences between EOPC and non-EOPC populations. We aimed to compare national patient characteristics and inpatient outcomes between these groups. Methods: We conducted a cross-sectional study using the 2016-2019 National Inpatient Sample of adult (age >18 years) hospitalizations with PC. PC and clinical outcomes were identified with ICD-10-CM diagnosis and procedures codes. The Charlson Comorbidity Index (CCI) was used to calculate comorbidities. Descriptive analyses were performed with chi-square tests. Multivariable logistic regression was used to evaluate the association between EOPC and clinical outcomes, adjusting for demographics, CCI, cancer stage, hospital region, and type of admission. Survey weights were applied to generate national estimates. Results: Among 417,830 weighted hospitalizations of patients with pancreatic cancer, 23,225(5.6%) were classified as EOPC. The mean age of EOPC patients was 43.4 years versus 69.6 years in non-EOPC (p < 0.0001). Compared with non-EOPC hospitalizations, EOPC patients were more likely to belong to a racial or ethnic minority population (41.6% vs 28.0%), be in the lowest median household income quartile (30.3% vs 24.9%), reside in a metropolitan region (33.2% vs 29.9%), and present with metastatic disease (57.9% vs 51.8%) (all p < 0.0001). There was no significant difference in sex distribution between the groups (male: 51.7% vs 51.2%, p = 0.488). After adjustment, EOPC was independently associated with increased odds of sepsis (aOR 1.17, 95% CI: 1.05-1.29, p = 0.004), pulmonary embolism (aOR 1.40, 95% CI: 1.30-1.50, p < 0.0001), acute respiratory failure (aOR 1.20, 95% CI: 1.03-1.40, p = 0.02), and pancreatic surgery (aOR 1.16, 95% CI: 1.11-1.22, p < 0.0001). No significant association was found with mortality, deep vein thrombosis, and disseminated intravascular coagulation. Conclusions: With the rising incidence of EOPC, it is increasingly important to characterize this subset of patients. Our data reveals that EOPC patients experience substantial disparities, notably increased minority representation, lower socioeconomic status, and delayed presentation. Moreover, despite younger age, EOPC was independently associated with a disproportionately increased risk of severe inpatient complications. These findings underscore the need for earlier detection and equity focused interventions in this patient population. To extend, further research is warranted to better define the biological, environmental, and health system factors contributing to outcomes in EPOC.
Bono et al. (Thu,) studied this question.