P0010 - Gender Disparities in Pancreatic Cancer Mortality Rates: A Population-Based Time-Trend Analysis Using the Surveillance, Epidemiology, and End Results (SEER) Database

Sunday, October 24, 2021

3:30 PM – 7:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Yazan Abboud, MD

Cedars-Sinai Medical Center
Los Angeles, CA, United States

Yazan Abboud, MD, Janice E. Oh, MD, MS, Jamil Samaan, MD, Nicholas Nissen, MD, Simon Lo, MD, Srinivas Gaddam, MD
Cedars-Sinai Medical Center, Los Angeles, CA

Introduction: Pancreatic cancer (PC) continues to have a 5-year survival rate of 10% and is projected to be the second leading cause of mortality in the US by 2030. However, there is limited data on mortality rates and time-trends. The aim of this study was to conduct a time-trend analysis of incidence-based mortality rates (IBMRs) in a large population-based cohort.

Methods: PC IBMRs per 100,000 population (age-adjusted to the 2000 US population) from 2002 to 2018 were computed from the SEER 18 database using SEER*Stat software (v8.3.9) and were stratified by gender. Trends were quantified using the Joinpoint Regression Program (v4.9). The annual percentage change (APC) and the average APC (AAPC) were estimated and evaluated using parametric estimations with p-values indicating whether they are significant (increasing or decreasing trends) or non-significant (stable trends). Pairwise comparison between the AAPCs of the trends was conducted to assess if the trends were identical (test of coincidence). Further age and gender-specific analysis was conducted to evaluate for variations in mortality rates and time-trends.

Results: During 2002-2018, a total of 170,736 people died from PC (50% men). The trends were increasing significantly in women (AAPC=0.44, p< 0.01) and men (AAPC=0.78, p< 0.01) at significantly different IBMRs (p< 0.01) (table). However, stratified analysis of different age groups showed variation of trends between women and men. Among PC patients aged ≥50, AAPC was significantly increasing in both men (AAPC=0.85, p< 0.01) and women (AAPC=0.49, p< 0.01) at significantly different IBMRs (p< 0.01). However, among people aged 15-49, AAPC was significantly decreasing in men (-0.87, p=0.03), but stable in women (-0.70, p=0.20). The two groups also had significantly different IBMRs (p< 0.001) suggesting that statistically, the gender-specific AAPC rates were different (figure).

Discussion: Mortality from pancreatic cancer appear to be improving in young (< 50 years) men but the same trend is not seen in young women. The cause of gender disparity in PC outcomes is unclear. Future studies should attempt to elucidate the causes of this disparity.

Figure: Figure: Pancreatic cancer gender-specific incidence-based mortality trends and age-adjusted rates per 100,000 population among multiple age-specific groups.
A: The average annual percentage rate (AAPC) is significantly increasing in both men (0.78, p<0.001) and women (0.44, p<0.001) among people of all ages.
B: The average annual percentage rate (AAPC) is significantly increasing in men (0.85, p<0.001) and women (0.49, p<0.001) among people aged ≥50.
C: The AAPC is significantly decreasing in men (-0.87, p=0.03) but stable in women (-0.70, p=0.204) among people aged 15-49.

Age range, y	Trends				AAPC		Pairwise comparison between gender-specific trends (Test of Coincidence p-value***)
Age range, y	Time period	APC (95% CI)	Time period	APC (95% CI)	Value	Difference between gender-specific AAPCs**
All ages
Men	2002-2005	3.12* (0.72-5.59)	2005-2018	0.26* (0.03-0.46)	0.78*	0.34	0.0002
Women	2002-2018	0.44* (0.24-0.63)			0.44*
Aged ≥50
Men	2002-2005	3.21* (1.02-5.44)	2005-2018	0.32* (0.12-0.51)	0.85*	0.37	0.0002
Women	2002-2018	0.49* (0.31-0.66)			0.49*
Aged 15-49
Men	2002-2018	-0.87* (-1.64- -0.10)			-0.87*	-0.17	0.0002
Women	2002-2018	-0.70 (-1.83-0.43)			-0.70

Table: Table: Pancreatic cancer gender-specific incidence-based mortality trends and age-adjusted rates per 100,000 population among age-specific populations.
* Indicates that the annual percentage change (APC) or the average APC (AAPC) is significantly different from zero at the alpha=0.05 (the trend is increasing or decreasing).
** A negative value is associated with a higher AAPC in women. However, none of the AAPC differences were statistically significant at the alpha=0.05.
*** Tests whether gender-specific trends are identical. A significant p-value indicates that the trends are not identical, i.e., they have different mortality rates (coincidence is rejected).

Disclosures:

Yazan Abboud indicated no relevant financial relationships.

Janice Oh indicated no relevant financial relationships.

Jamil Samaan indicated no relevant financial relationships.

Nicholas Nissen indicated no relevant financial relationships.

Simon Lo indicated no relevant financial relationships.

Srinivas Gaddam indicated no relevant financial relationships.

Yazan Abboud, MD, Janice E. Oh, MD, MS, Jamil Samaan, MD, Nicholas Nissen, MD, Simon Lo, MD, Srinivas Gaddam, MD. P0010 - Gender Disparities in Pancreatic Cancer Mortality Rates: A Population-Based Time-Trend Analysis Using the Surveillance, Epidemiology, and End Results (SEER) Database, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.