What question did this study set out to answer?

The study aims to quantify racial differences in pancreatic cancer survival and evaluate contributing factors.

April 19, 2026American Journal of Clinical Oncology0 citationsOpen Access

Racial Disparities in Pancreatic Cancer

ADArkadeep Dhali SMSaikat Mandal MAMuhammad Asad

Key Points

The study aims to quantify racial differences in pancreatic cancer survival and evaluate contributing factors.
Conducted a retrospective cohort study using SEER data.
Included adults with malignant pancreatic neoplasms, excluding those with unknown race or missing data.
Classified race as White, Black, or Other.
Performed Kaplan-Meier survival analysis, multivariable Cox regression, and propensity-score matching.
Median overall survival was 6 months for White and Other groups, and 5 months for Black patients.
Five-year overall survival rates were 8.8% for White, 8.2% for Black, and 10.7% for Other populations.
Black race associated with worse overall survival (HR 1.097) and cancer-specific survival (HR 1.064) versus White.
Surgical receipt was lower in Black patients (13.9% vs. 16.6%) and had adjusted odds of surgery (OR 0.717).
Surgery and income accounted for part of the survival disparity, leaving 56.1% unexplained.

Abstract

Objectives: Racial disparities in pancreatic cancer outcomes remain incompletely explained. Using a large population-based data set, we quantified racial differences in survival and evaluated mediators, including surgical access, treatment timeliness, and area-level socioeconomic status. Methods: We conducted a retrospective cohort study using SEER data. Adults with malignant pancreatic neoplasms were included; patients with unknown race or missing survival data were excluded. Race was classified as White, Black, or Other. Coprimary outcomes were overall survival (OS) and cancer-specific survival (CSS). Analyses included Kaplan-Meier survival analysis, multivariable Cox regression, and propensity-score matching. Results: The cohort comprised 162,783 patients: White 130,374 (80.1%), Black 18,858 (11.6%), and Other 13,551 (8.3%). Median OS was 6, 5, and 6 months; 5-year OS was 8.8%, 8.2%, and 10.7%, respectively ( P <0.001). The Black race was associated with worse OS (HR 1.097; 95% CI: 1.079-1.115) and CSS (HR 1.064; 95% CI: 1.046-1.083) versus White. After matching (18,858 pairs), the Black race remained associated with worse OS (HR 1.158; 95% CI: 1.131-1.185) and CSS (HR 1.121; 95% CI: 1.094-1.148). Black patients had lower surgical receipt (13.9% vs. 16.6%), lower adjusted odds of surgery (OR 0.717; 95% CI: 0.684-0.752), and longer time-to treatment (37.0 vs. 33.2 d). Surgery explained 26.3% of the disparity, and income explained 14.2%; 56.1% remained unexplained. Conclusions: Black patients with pancreatic cancer had worse OS and CSS than White patients, only partly explained by lower surgical receipt and socioeconomic differences.

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