Pancreatic Cancer Death Rates Changing Along Racial Lines

Trends in pancreatic mortality have gone in opposite directions for blacks and whites during the last few decades, a pattern which cannot be explained by known risk factors, according to researchers from the American Cancer Society, who recently published their study in the Journal of the National Cancer Institute.

Researchers led by Jiemin Ma, PhD, now of Brigham and Women’s Hospital, used data from the National Center for Health Statistics and a Joinpoint regression model to calculate the annual percentage change in pancreatic death rates from 1970 to 2009 by sex and race among adults aged 35 to 84 years.

Although overall rates for pancreatic cancer death were consistently higher for blacks than whites, data indicated an interesting pattern with death rates moving in opposite directions for each race. White men had a decrease in pancreatic cancer death rates of 0.7% per year from 1970 to 1995, followed by an increase of 0.4% per year through 2009. Similarly, white women saw small increases in death rates from 1970 to 1984, with rates stabilizing in the 1990s. However, through 2009 they saw an increase of 0.5% pancreatic deaths per year.

By comparison, black men had increases of 0.5% per year from 1970 to 1989, and then decreases of 0.9% per year through 2009. Similarly, black women had rates increase by 1.3% per year from 1970 to 1989, and then decrease by 0.5% through 2009.

“The decreasing trend in blacks over the past 10 to 15 years is particularly interesting because the prevalence rates of factors (ie, obesity, diabetes, and improved diagnosis) that are likely contributing to the recent increase in pancreatic cancer death rates in whites have also increased in blacks,” the researchers wrote.

In an editorial that accompanied this article, Dana B. Cardin, MD, and Jordan D. Berlin, MD, of Vanderbilt Ingram Cancer Center discussed some of the steps that are needed to begin to combat these trends. The first discussed was an increase in government support of policies that support healthy lifestyle choices.

“Currently, the US Farm Subsidy Program provides roughly $200 billion in farm subsidies, mostly to meat producers, foods used as sweeteners, and ethanol-based crops, but no regular direct payments to fruit or vegetable farmers,” they wrote. “This conflicts with the government’s healthy eating guidelines that tout more fruits and vegetables and fewer sugars and meats.”

Additionally, Cardin and Berlin said that increased attention toward early detection of the disease is crucial, with only a minority of pancreatic cancers caught early. Finally, they said that better therapies discovered through research and clinical trials are essential.

“A recent report by the Pancreatic Cancer Action Network analyzed open clinical trials and patient accrual, and their calculations estimate that only 4.6% of newly diagnosed pancreas cancer patients enrolled in clinical trials in 2011,” they wrote. “The article by Ma et al in this issue of the journal highlights a looming crisis of rising pancreatic cancer death rates in the United States.”