Pancreatic cancer among Pacific Islanders: a comprehensive analysis of an understudied racial group

ABSTRACT

Objective

Racial disparities in care and outcome have been demonstrated for several cancers, but it is not clear that a similar discrepancy exists for pancreatic cancer. Furthermore, there are limited data describing the pancreatic cancer experience of Pacific Islanders. The primary objective of this study was to analyze the clinical characteristics, treatment, and outcomes of Pacific Islander patients with pancreatic cancer.

Design

We obtained data for a consecutive sample of pancreatic adenocarcinoma patients who presented to the largest hospital in Hawaii from 1 January 2000, through 31 December 2019. Analyses were performed for the entire population and separately for patients who had their cancer resected. Overall survival was calculated by the Kaplan–Meier method. Cox proportional hazards regression models were constructed to determine the prognostic capacity of clinical and pathologic factors.

Results

A total of 1040 patients were included in the final analysis. Pacific islanders presented at a significantly younger age compared to Whites or Asians and had the highest Medicaid rate. There were no statistically significant racial differences in stage at presentation or treatments. We did not demonstrate an association between race and survival on univariate analysis, nor after adjusting for demographic and tumor factors. Age, stage, and treatment were significantly associated with survival for both univariate and multivariate analyses.

Conclusion

We did not demonstrate disparate outcomes among Pacific Islanders with pancreatic cancer. This is likely due in part to the absence of a screening test and the notable poor prognosis of pancreatic adenocarcinoma. Furthermore, equity in treatment may have contributed to racial parity in survival.

KEYWORDS:

• Race
• pancreatic cancer
• native Hawaiian
• Pacific Islander
• Asian
• racial disparities

Acknowledgements

Jared D. Acoba – conceptualization, formal analysis, writing – original draft; Trent Hirano – formal analysis, writing – original draft; Ryon Nakasone – writing – review and editing; Young S Rho – writing – review and editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.