South Asian Americans Have Lower Rates of Pancreatic Cancer Mortality: A SEER Database Analysis

Introduction: Pancreatic cancer is a fatal malignancy, with the highest incidence and mortality being found in developed countries. Its prevalence has slowly increased over time. We used the SEER database to analyze differences in incidence and mortality rates of cancer in the South Asian populations compared to other races within the US. Methods: Data from 2004-2015 was extracted from the Surveillance, Epidemiology and End Results (SEER) program for analysis. For the purpose of this study and due to constrictions in how the data is reported in SEER, South Asian was defined as a designation of Asian Indian or Pakistani. Control groups included White, Black, and Hispanic patient populations. Site, stage, and mortality were compared among the groups using t-test analysis. Results: Analysis showed a statistically significant difference between Indian/Pakistani Americans and White/Black/Hispanic Americans largely in regards to grading. When assessing for staging at time of diagnosis, South Asians predominantly were diagnosed during Stage 4 (44.3%). While lower than the Black (49.8%) and Hispanic (47.3%) counterparts, there was no statistically significant difference (p > 0.05). However, South Asians were found to have a higher incidence of Stage 2 (24.5%) compared to Black populations (18.9%) at a statistical significance of p = 0.007. South Asians had the highest rate of Grade 1 (24.8%) with statistical significance against White (17.7%), Black (17.6%), and Hispanic (17.5%) populations at P-values of 0.043, 0.046, and 0.043 respectively. South Asians also reported the lowest rate of mortality, at 77.1% with statistical significance of p < 0.001 between all other groups including White (86.6%), Black (83.8%), and Hispanic (84.2%) Conclusion: The findings suggest that the characteristics and mortality of pancreatic cancer varies by race and ethnicity. This differentiation may be due to cultural tendencies, since the majority of risk factors for pancreatic cancer are based on lifestyle. The difference in initial histologic grading may also explain the differences in mortality. Further understanding of the differences between different races and ethnicities will help with future prevention recommendations.