Abstract

We summarize the risk factors that may significantly contribute to racial disparities in pancreatic cancer, which is now the third leading cause of cancer deaths and projected to be second around 2030 in 12 years. For decades, the incidence rate of pancreatic cancer among Blacks has been 30% to 70% higher than other racial groups in the United States and the 5-year survival rate is approximately 5%. Diabetes and obesity have been identified as potentially predisposing factors to pancreatic cancer and both are more common among Blacks. Smoking continues to be one of the most important risk factors for pancreatic cancer and smoking rates are higher among Blacks compared to other racial groups. The overall risk of pancreatic cancer due to changes in DNA is thought to be the same for most racial groups; however, DNA methylation levels have been observed to be significantly different between Blacks and Whites. This finding may underlie the racial disparities in pancreatic cancer. Identification and prevention of these factors may be effective strategies to reduce the high incidence and mortality rates for pancreatic cancer among Blacks.

Highlights

  • Known lifestyle risk factors for pancreatic cancer include obesity, diabetes, and tobacco use, which are associated with cancer incidence and mortality

  • 30.0 and 34.9 had an associated increased risk for pancreatic cancer mortality (HR = 1.25; 95% CI, 0.99–1.57) compared to those with a body mass index (BMI) between 25.0 and 29.9 (HR = 1.08; 95% CI, 0.90–1.31) [9]. These findings indicate that obesity may be a contributing factor to pancreatic cancer, but it does not necessarily explain the disparities in the incidence or mortality rates for Blacks

  • This finding suggests that the status of DNA methylation at pre-cancer stages may play a critical role in later racial differences in the incidence and mortality rates of pancreatic cancer

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Summary

A Commentary

Lisa Scarton 1 ID , Saunjoo Yoon 2 ID , Sungho Oh 2 , Edward Agyare 3 , Jose Trevino 4, *, Bo Han 5 , Eunsook Lee 6 , Veronica Wendy Setiawan 7 , Jennifer B.

Introduction
Pancreatic Cancer Statistics
Socioeconomic Factors
Lifestyle Factors
Biological Factors Potentially Contributing to Disparities
Zinc Deficiency Factor
Genomic Factors
Findings
Conclusions
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