Pancreatic cancer mortality trends (2018-2023): Exposing racial inequities in Michigan's cancer burden

Document Type

Conference Proceeding

Publication Date

5-28-2025

Publication Title

J Clin Oncol

Abstract

Background: Pancreatic cancer remains one of the most aggressive malignancies, with Black individuals facing significantly worse outcomes and a younger age of onset. Despite overall survival improvements in cancer care, racial disparities in pancreatic cancer continue to widen. This study analyzes Michigan's diverse population to quantify disparities and identify actionable solutions for healthcare equity. Methods: This observational study analyzed pancreatic cancer mortality patterns across Michigan in adults aged 25 and older were retrieved from the CDC WONDER database (2018-2023) using ICD-10 codes for malignant neoplasm of the pancreas. Crude mortality rates (CMRs) and Age-adjusted mortality rates (AAMRs) per 100,000 were calculated by age, gender and race, with 95% confidence intervals (CI) for precision to assess racial disparities in mortality outcomes. Temporal trends and annual percentage changes (APCs) were analyzed using Joinpoint regression. Results: From 2018-2023, Michigan reported 10,162 pancreatic cancer deaths, with Black residents (14.1% of the population) accounting for 1,289 and White residents (who make up 78.9%) for 8,664 deaths. Overall, CMR was higher for White residents (18.26 per 100,000) than Black residents (15.21 per 100,000) who experienced a sharper rise in AAMR, increasing by 8.10% [14.36 (13.55-15.16)] compared to 4.92% [12.36 (12.10-12.63)] for White residents. For Black residents, CMRs increased with age, rising from 8.14 per 100,000 (45-54 years) to 105.78 per 100,000 (85+ years), peaking at 69.46 (65-74 years) and 95.37 (75-84 years). White residents had lower CMRs overall, starting at 1.48 per 100,000 (35-44 years) and gradually increasing to 115.28 per 100,000 in the 85+ group.In Washtenaw County, Black residents had a rate of 14.01 per 100,000 and White residents 15.79 per 100,000 with similar trends in Genesee, Wayne, and Ingham counties. Treatment inequities compounded these disparities: Black patients faced 38% lower odds of surgery, 45% longer delays for chemotherapy, and 27% lower clinical trial enrollment. These findings highlight significant racial disparities in pancreatic cancer mortality, treatment access, and outcomes, underscoring the need for targeted public health interventions. Conclusions: Our findings reveal significant racial disparities in pancreatic cancer outcomes in Michigan, with Black residents experiencing higher mortality rates and a younger age of death than White residents. These disparities reflect systemic barriers, including delayed diagnosis, fewer surgeries, and limited access to specialized care. Addressing these inequities requires bias training, targeted screening for high-risk Black populations, and expanded oncology services, while actionable solutions such as patient navigation and community-based screening programs can help bridge this healthcare gap and promote equity.

Volume

43

Issue

16

Find It @ Sladen

Share

COinS