Abstract
While disparity in pancreatic cancer incidence between blacks and whites has been observed, few studies have examined disparity in other ethnic minorities. We evaluated variations in pancreatic cancer incidence and assessed the extent to which known risk factors account for differences in pancreatic cancer risk among African Americans, Native Hawaiians, Japanese Americans, Latino Americans, and European Americans in the Multiethnic Cohort Study. Risk factor data were obtained from the baseline questionnaire. Cox regression was used to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for pancreatic cancer associated with risk factors and ethnicity. During an average 16.9‐year follow‐up, 1,532 incident pancreatic cancer cases were identified among 184,559 at‐risk participants. Family history of pancreatic cancer (RR 1.97, 95% CI 1.50‐2.58), diabetes (RR 1.32, 95% CI 1.14‐1.54), body mass index ≥30 kg/m2 (RR 1.25, 95% CI 1.08‐1.46), current smoking (<20 pack‐years RR 1.43, 95% CI 1.19‐1.73; ≥20 pack‐years RR 1.76, 95% CI 1.46‐2.12), and red meat intake (RR 1.17, 95% CI 1.00‐1.36) were associated with pancreatic cancer. After adjustment for these risk factors, Native Hawaiians (RR 1.60, 95% CI 1.30‐1.98), Japanese Americans (RR 1.33, 95% CI 1.15‐1.54), and African Americans (RR 1.20, 95% CI 1.01‐1.42), but not Latino Americans (RR 0.90, 95% CI 0.76‐1.07), had a higher risk of pancreatic cancer compared to European Americans. Interethnic differences in pancreatic cancer risk are not fully explained by differences in the distribution of known risk factors. The greater risks in Native Hawaiians and Japanese Americans are new findings and elucidating the causes of these high rates may improve our understanding and prevention of pancreatic cancer.
Highlights
Pancreatic cancer is one of the deadliest malignancies in the United States
African Americans have had historically higher rates of pancreatic cancer incidence compared to whites.[14]
While risk factors such as obesity, diabetes, and smoking are more prevalent among African Americans, past research has suggested that they do not fully explain the differences in pancreatic cancer incidence.[15,16]
Summary
Pancreatic cancer is one of the deadliest malignancies in the United States It has a 5‐year survival rate of only 8% and is the third most common cancer‐related death among men and women.[1] By 2030, pancreatic cancer is estimated to surpass colorectal cancer to become the second leading cause of cancer mortality.[2] Given these circumstances, a better understanding of its risk factors is imperative for preventing pancreatic cancer occurrence. There is limited information as to whether risk factors identified in past literature explain varying degrees of pancreatic cancer incidence between racial/ethnic subpopulations
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