Incidence Rates Of Pancreatic Cancer Research Articles

Changing Trends in the Global Disease Burden of Pancreatic Cancer from 1990 to 2030

Changing Trends in the Global Disease Burden of Pancreatic Cancer from 1990 to 2030

Abstract 4427: Do changes in lipid metabolism link obesity to pancreatic cancer

Abstract The near equal incidence and mortality rates of pancreatic cancer, combined with projections that pancreatic cancer will become the second-most common cancer-related deaths by 2050, underscore the need to identify patients with early disease and interrupt this trajectory. Obesity, weight gain and waistline have been implicated in increasing the risk of pancreatic cancer. Although metabolomic analyses of pancreatic cancer patients have established correlations between phospholipids, lysophospholipids with treatment outcomes, the association between metabolites, obesity, and pancreatic cancer remains largely understudied. The objective of this pilot study was to determine differences in serum metabolites in obese and overweight pancreatic cancer patients compared with healthy non-obese subjects. Our long-term goal is to develop serum marker(s) that may be used to prevent advanced pancreatic cancer and thus improve outcomes for these patients. Serum was obtained from healthy subjects (n=11; BMI range from 18-25), overweight (n=9; 25-30) and obese (n=7; >30) pancreatic cancer patients from an IRB approved study. Males (n=12) and females (n=15) were represented in the study. Global metabolic profiles were determined using Ultrahigh performance liquid chromatography-tandem mass spectroscopy. Raw data was extracted, peaks were identified and processed at Metabolon using the Laboratory Information Management System. Comparison between overweight pancreatic cancer patients and healthy controls identified 403 biochemicals (111 upregulated and 292 downregulated; p <0.05) and 93 biochemicals (40 upregulated and 53 downregulated; 0.05<p<0.10). Comparison of the differences in biochemicals between obese pancreatic cancer patients and healthy controls showed changes in 293 biochemicals (71 upregulated and 222 downregulated; p <0.05) and 123 biochemical changes at 0.05<p<0.10 (42 increased and 81 decreased). 38 (p <0.05) and 47 (0.05<p<0.10) differential levels of biochemicals were identified when obese and overweight pancreatic cancer patients were compared. Random forest analysis showed that the 30 top ranking biochemicals were involved in lipid metabolism, amino acid metabolism, nucleotide metabolism, peptide, xenobiotics, and carbohydrate metabolism. These data suggest an association between changes in lipid metabolism may be another link between obesity and pancreatic cancer. This project was funded in part by VA-Merit Award (I01 BX003876). Citation Format: Rita Ghosh, Deepa Ajit, Jillian Woodworth, Danielle Fritze, Francisco G. Cigarroa, Glenn A. Halff, Addanki Pratap Kumar. Do changes in lipid metabolism link obesity to pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4427.

Association between Cholecystectomy and the Incidence of Pancreaticobiliary Cancer after Endoscopic Choledocholithiasis Management.

(1) Background: Previous studies have raised concerns about a potential increase in pancreaticobiliary cancer risk after cholecystectomy, but few studies have focused on patients who undergo cholecystectomy after receiving endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. This study aims to clarify cancer risks in these patients, who usually require cholecystectomy, to reduce recurrent biliary events. (2) Methods: We conducted a nationwide cohort study linked to the National Health Insurance Research Database, the Cancer Registry Database, and the Death Registry Records to evaluate the risk of pancreaticobiliary cancers. All patients who underwent first-time therapeutic ERCP for choledocholithiasis from 2011 to 2017 in Taiwan were included. We collected the data of 13,413 patients who received cholecystectomy after endoscopic retrograde cholangiopancreatography and used propensity score matching to obtain the data of 13,330 patients in both the cholecystectomy and non-cholecystectomy groups with similar age, gender, and known pancreaticobiliary cancer risk factors. Pancreaticobiliary cancer incidences were further compared. (3) Results: In the cholecystectomy group, 60 patients had cholangiocarcinoma, 61 patients had pancreatic cancer, and 15 patients had ampullary cancer. In the non-cholecystectomy group, 168 cases had cholangiocarcinoma, 101 patients had pancreatic cancer, and 49 patients had ampullary cancer. The incidence rates of cholangiocarcinoma, pancreatic cancer, and ampullary cancer were 1.19, 1.21, and 0.3 per 1000 person-years in the cholecystectomy group, all significantly lower than 3.52 (p < 0.0001), 2.11 (p = 0.0007), and 1.02 (p < 0.0001) per 1000 person-years, respectively, in the non-cholecystectomy group. (4) Conclusions: In patients receiving ERCP for choledocholithiasis, cholecystectomy is associated with a significantly lower risk of developing pancreaticobiliary cancer.

Cancer burden and risk in the Chinese population aged 55 years and above: A systematic analysis and comparison with the USA and Western Europe.

We analysed the cancer burden among elderly Chinese people over the age of 55 years and compared them to USA and Western Europe to explore the cancer model in China. We retrieved data on 29 cancers with 34 risk factors from the 2019 Global Burden of Disease database to evaluate the cancer burden in Chinese elderly individuals aged 55 years and older. We then used the age-standardised incidence rate (ASIR), age-standardised death rate (ASDR), age-standardised disability-adjusted life year (DALY) rate, and average annual percentage change (AAPC) to compare the characteristics and change trend of cancers among China, USA, and Western Europe. In 2019, the number of incident cases of 29 cancers among people aged 55 years and above in China increased more than 3-fold compared to 1990, while the number of deaths and DALYs approximately doubled. We also found that the cancer population in China was ageing; meanwhile, the cancer burden became significantly higher for men than for women, and the gap between men and women had widened. Cancers with the highest cancer DALYs were lung cancer (13 444 500; 95% uncertainty interval (UI) = 11 307 100, 15 853 700), stomach cancer (7 303 900; 95% UI = 6 094 600, 8 586 500), oesophageal cancer (4 633 500; 95% UI = 3 642 500, 5 601 200), colon and rectum cancer (4 386 500; 95% UI = 3 769 500, 5 067 200), liver cancer (2 915 100, 95% UI = 2 456 300, 3 463 900), and pancreatic cancer (2 028 400; 95% UI = 1 725 000, 2 354 900). Compared with 1990, the DALY rate and incidence rate of stomach cancer, oesophageal cancer, and liver cancer had markedly decreased. The DALY rate and incidence rate of lung, colon, rectum, and pancreatic cancer had increased significantly, as did the incidence rate of breast cancer in women. Smoking and diet were the top two cancer risk factors, and the impact of ambient particulate matter pollution on cancer increased each year. The overall 29 cancers age-standardised DALY rate and ASDR in China, USA, and Western Europe were similar, and all showed downward trend in the past 30 years. Compared with the USA and Western Europe, the age-standardised DALY rate of liver, nasopharyngeal, oesophageal, stomach, and cervical cancers in China was more prominent. The age-standardised DALY rate of lung cancer and colon and rectum cancer decreased annually in Western Europe and the USA, but increased in China. Over the past 30 years, China had made progress in controlling stomach, oesophageal, and liver cancer. However, lung, colon, rectum, pancreatic, and breast cancers had become more prevalent, having risen alongside economic development. The risks of smoking and dietary were major issues that need to be addressed urgently. The cancer situation in China remains serious; future cancer prevention efforts need to balance economic development with people's physical health, identify key groups, improve the health environment of residents and guide them to live a healthy life, and expand the scope of cancer screening.

Long-Term Outcomes and Risk of Pancreatic Cancer in Intraductal Papillary Mucinous Neoplasms

Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can give rise to pancreatic cancer (PC). Limited population data exist on their prevalence, natural history, or risk of malignant transformation (IPMN-PC). To fill knowledge gaps in epidemiology of IPMNs and associated PC risk by estimating population prevalence of IPMNs, associated PC risk, and proportion of IPMN-PC. : This retrospective cohort study was conducted in Olmsted County, Minnesota. Using the Rochester Epidemiology Project (REP), patients aged 50 years and older with abdominal computed tomography (CT) scans between 2000 and 2015 were randomly selected (CT cohort). All patients from the REP with PC between 2000 and 2019 were also selected (PC cohort). Data were analyzed from November 2021 through August 2023. CIs for PC incidence estimates were calculated using exact methods with the Poisson distribution. Cox models were used to estimate age, sex, and stage-adjusted hazard ratios for time-to-event end points. The CT cohort included 2114 patients (1140 females [53.9%]; mean [SD] age, 68.6 [12.1] years). IPMNs were identified in 231 patients (10.9%; 95% CI, 9.7%-12.3%), most of which were branch duct (210 branch-duct [90.9%], 16 main-duct [6.9%], and 5 mixed [2.2%] IPMNs). There were 5 Fukuoka high-risk (F-HR) IPMNs (2.2%), 39 worrisome (F-W) IPMNs (16.9%), and 187 negative (F-N) IPMNs (81.0%). After a median (IQR) follow-up of 12.0 (8.1-15.3) years, 4 patients developed PC (2 patients in F-HR and 2 patients in F-N groups). The PC incidence rate per 100 person years for F-HR IPMNs was 34.06 incidents (95% CI, 4.12-123.02 incidents) and not significantly different for patients with F-N IPMNs compared with patients without IPMNs (0.16 patients; 95% CI, 0.02-0.57 patients vs 0.11 patients; 95% CI, 0.06-0.17 patients; P = .62). The PC cohort included 320 patients (155 females [48.4%]; mean [SD] age, 72.0 [12.3] years), and 9.8% (95% CI, 7.0%-13.7%) had IPMN-PC. Compared with 284 patients with non-IPMN PC, 31 patients with IPMN-PC were older (mean [SD] age, 76.9 [9.2] vs 71.3 [12.5] years; P = .02) and more likely to undergo surgical resection (14 patients [45.2%] vs 60 patients [21.1%]; P = .003) and more-frequently had nonmetastatic PC at diagnosis (20 patients [64.5%] vs 130 patients [46.8%]; P = .047). Patients with IPMN-PC had better survival (adjusted hazard ratio, 0.62; 95% CI, 0.40-0.94; P = .03) than patients with non-IPMN PC. In this study, CTs identified IPMNs in approximately 10% of patients aged 50 years or older. PC risk in patients with F-N IPMNs was low and not different compared with patients without IPMNs; approximately 10% of patients with PC had IPMN-PC, and they had better survival compared with patients with non-IPMN PC.

S43 The Incidence Rate of Pancreatic Cancer for Ages 50-Years and Above—SEER Based Study—Should We Start Screening for Pancreatic Cancer?

S43 The Incidence Rate of Pancreatic Cancer for Ages 50-Years and Above—SEER Based Study—Should We Start Screening for Pancreatic Cancer?

S41 Incidence, Incidence-Based Mortality, and Survival Rates of Pancreatic Cancer Based on the Extent of Disease: A SEER-Based Study

S41 Incidence, Incidence-Based Mortality, and Survival Rates of Pancreatic Cancer Based on the Extent of Disease: A SEER-Based Study

S42 Gender-Based Differences in Incidence, Incidence-Based Mortality and Survival Rates of Pancreatic Cancer: A SEER-Based Study

S42 Gender-Based Differences in Incidence, Incidence-Based Mortality and Survival Rates of Pancreatic Cancer: A SEER-Based Study

Dietary patterns in relation to incidence rate of pancreatic cancer - the Norwegian women and cancer cohort study.

Despite development in cancer treatment and prevention options during the past few years, cancer of the pancreas remains a diagnosis associated with poor prognosis and limited options for prevention. Diet has proven to be an important risk factor for development of many types of cancer, particularly for cancers of the digestive system. Still, evidence regarding its relation to pancreatic cancer remains ambiguous. To investigate the relationship between diet and pancreatic cancer, an analysis of dietary patterns in participants from the Norwegian Women and Cancer Study (n = 89,156; 305 pancreatic cancer cases) was performed. Cox regression analysis was used for studying possible associations between dietary patterns, derived from principal component analysis, and pancreatic cancer incidence. The four most prominent dietary patterns were identified and described: European pattern, animal food consumers' dietary pattern, traditional Norwegian pattern, and alcohol-abstaining dietary pattern. In analysis without adjustment for confounders, being in the highest tertile of the abstaining dietary pattern was associated with lower risk of pancreatic cancer in comparison to the lowest tertile (hazard ratios [HR]: 0.66, 95% confidence interval [CI]: 0.49-0.89). After additional adjustment for height and smoking status, no dietary pattern was associated with increased pancreatic cancer risk, nor was there any difference in effect estimates between strata of smokers and non-smokers. The results of our current analysis do not support the role of major dietary patterns in the development of pancreatic cancer.

Trends in pancreatic cancer incidence and mortality in the United States from 2000 to 2019: A SEER-based study.

755 Background: The annual incidence and mortality rates of pancreatic cancer has been rising. We analyzed pancreatic cancer trends by demographics and geographic location. Methods: Data obtained from the Surveillance, Epidemiology, and End Results (SEER) registry 17 were available to assess trends of pancreatic cancer incidence and mortality from 2000 to 2019. Results: The pancreatic cancer incidence and mortality rates consistently increased over time from 2000 to 2019. Incidence of pancreatic cancer was highest in males (14; 95% Cl, 13.9,14.1) and blacks (15.4 95% Cl,15.2, 15.6). The incidence was highest in Alaska (16.2; 95% Cl, 14.1, 18.5), and lowest in Utah (10.7; 95% Cl, 10.4, 11.0). Incidence increased at 0.85% per year (95% Cl, 0.76, 0.92; P &lt; .001). Overall incidence increased significantly for all sex, race, stage sub-groups except for Blacks (APC of 0.04%; 95% Cl, -0.14, 0.22; P = 0.649), and American Indian/Alaska natives (APC of -0.22 %; 95% Cl, -1.33, 0.89; P = 0.679). There was an overall significant increase in incidence across all states except for Alaska. Incidence-based mortality of pancreatic cancer was highest in males (12.6; 95% Cl, 12.5,12.7) and blacks (14.1; 95% Cl, 13.9, 14.3). Mortality was highest in Alaska (15.1; 95% Cl, 13.1,17.3), and lowest in Utah (9.6; 95% Cl, 9.3,9.9). Mortality increased at 0.91% per year (95% Cl, 0.32, 1.50; P = .005). The overall incidence-based mortality increased significantly only in the males APC, 0.95% (95% Cl, 0.36, 1.54; P = 0.003), females APC 1.18 (95% Cl, 0.47, 1.89; P = 0.002) and whites APC 1.05% (95% Cl, 0.45, 1.66; P = 0.002). Furthermore, there was an overall significant increase in incidence-based mortality across all states except for Alaska, Hawaii and Washington. Conclusions: Pancreatic cancer incidence and mortality rates increased overall but differed by demographics and geographic location.

Pancreatic Cancer Incidence Trends by Race, Ethnicity, Age and Sex in the United States: A Population-Based Study, 2000-2018.

Pancreatic cancer (PC) incidence is increasing at a greater rate in young women compared to young men. We performed a race- and ethnicity-specific evaluation of incidence trends in subgroups stratified by age and sex to investigate the association of race and ethnicity with these trends. Age-adjusted PC incidence rates (IR) from the years 2000 to 2018 were obtained from the SEER 21 database. Non-Hispanic White (White), Non-Hispanic Black (Black) and Hispanic patients were included. Age categories included older (ages ≥ 55) and younger (ages < 55) adults. Time-trends were described as annual percentage change (APC) and average APC (AAPC). Younger White [AAPC difference = 0.73, p = 0.01)], Black [AAPC difference = 1.96, p = 0.01)] and Hispanic [AAPC difference = 1.55, p = 0.011)] women experienced a greater rate of increase in IR compared to their counterpart men. Younger Hispanic women experienced a greater rate of increase in IR compared to younger Black women [AAPC difference = -1.28, p = 0.028)] and younger White women [AAPC difference = -1.35, p = 0.011)]. Younger women of all races and ethnicities experienced a greater rate of increase in PC IR compared to their counterpart men; however, younger Hispanic and Black women experienced a disproportionately greater increase. Hispanic women experienced a greater rate of increase in IR compared to younger Black and White women.

Trends in pancreatic cancer incidence and mortality in the United States from 2000 to 2019; a SEER based study

Background: The annual incidence and mortality rates of pancreatic cancer has been rising. We analyzed pancreatic cancer trends by demographics and geographic location. Methods: Data was obtained from the Surveillance, Epidemiology, and End Results (SEER) registry 17 were available to assess trends of pancreatic cancer incidence and mortality from 2000 to 2019. Results: The pancreatic cancer incidence and mortality rates consistently increased over time from 2000 to 2019. Incidence of pancreatic cancer was highest in males (14; 95% Cl, 13.9,14.1) and blacks (15.4 95% Cl,15.2, 15.6). The incidence was highest in Alaska (16.2; 95% Cl, 14.1, 18.5), and lowest in Utah (10.7; 95% Cl, 10.4, 11.0). Incidence increased at 0.85% per year (95% Cl, 0.76, 0.92; P &lt; .001). Overall incidence increased significantly for all sex, race, stage sub-groups except for Blacks (APC of 0.04%; 95% Cl, -0.14, 0.22; P = 0.649), and American Indian/Alaska natives (APC of -0.22 %; 95% Cl, -1.33, 0.89; P= 0.679). There was an overall significant increase in incidence across all states except for Alaska. Incidence-based mortality of pancreatic cancer was highest in males (12.6; 95% Cl, 12.5,12.7) and blacks (14.1; 95% Cl, 13.9, 14.3). Mortality was highest in Alaska (15.1; 95% Cl, 13.1,17.3), and lowest in Utah (9.6; 95% Cl, 9.3,9.9). Mortality increased at 0.91% per year (95% Cl, 0.32, 1.50; P = .005). The overall incidence-based mortality increased significantly only in the males APC, 0.95% (95% Cl, 0.36, 1.54; P = 0.003), females APC 1.18 (95% Cl, 0.47, 1.89; P = 0.002) and whites APC 1.05% (95% Cl, 0.45, 1.66; P = 0.002). Furthermore, there was an overall significant increase in incidence-based mortality across all states except for Alaska, Hawaii and Washington. Conclusion: Pancreatic cancer incidence and mortality rates increased overall but differed by demographics and geographic location.

An ecological study of the incidence and mortality rates of pancreatic cancer in 2020: exploring gender disparities worldwide

Introduction: Pancreatic cancer is a highly mortal disease that used to be rare but its incidence rate has increased in the last few decades. Despite declining overall cancer incidence and mortality rates in developed countries, pancreatic cancer tends to increase in both incidence and mortality. Previous studies showed a male predominance in pancreatic cancer in patients older than 35. However, considering the sudden rise in incidence in young females, a new survey is crucial to address the current pattern of pancreatic cancer distribution between males and females. Hormonal factors may play a role in the pathogenesis of pancreatic cancer. Objectives: This study aimed to evaluate the role of gender differences in mortality and incidence of pancreatic cancer in an ecological study based on data extracted from the GLOBOCAN project in 2020. Patients and Methods: An ecological study was carried out to assess gender disparity in pancreatic cancer incidence and mortality rates. The data used in the study were obtained from the Global Cancer (GLOBOCAN) project of the World Health Organization (WHO) in 2020 (https://gco.iarc.fr/). Results: The pancreatic cancer mortality rate worldwide (2020) was estimated at 466,003 cases, encompassing 246,840 cases (52.96%) among males and 219,163 cases (47.04%) among females. The study found that although there were differences in the mean pancreatic cancer incidence and mortality rates between males and females when measured by indicators such as number, ASR, and crude rate, these differences were not statistically significant. Conclusion: In conclusion, the pancreatic cancer incidence and mortality rate is increasing worldwide. In spite of the fact that men die from pancreatic cancer at a higher rate than women, there is no statistically significant difference between the two. Registration: The study protocol was registered on the Research Registry website with the unique identification number (UIN) researchregistry9598.

The Adverse Effect of Analgesics and Coeliac Plexus Block for the Relief of Pain in Carcinoma of Pancreas – A Prospective Observational Study

Introduction: Pancreatic cancer is a formidable health problem with increasing incidence. Worldwide, over 200000 people die annually of pancreatic cancer Because of high fatality rates; pancreatic cancer incidence rates are almost equal to mortality rates. Pancreatic cancer is diagnosed late in the natural history of the disease, given the few early indicators of illness, and the lack of screening tests for this disease. Neurolytic celiac plexus block (NCPB) is commonly used to treat pain of upper abdominal cancer that fails to respond to narcotic analgesics. CPB refers to the temporary inhibition of the celiac plexus often achieved with a corticosteroid injection in patients with benign pancreatic diseases like chronic pancreatitis. Aim of the study: The aim of this study was to determine and compare the adverse effect of analgesics and coeliac plexus block in relieving pain in carcinoma of pancreas. Methods: This study was a randomized comparative study and was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from July, 2008 to June, 2009. A total number of 60 patients were enrolled in this study. All patients were divided into two groups- Group A (treated with NCPB) &amp; Group B (treated with conventional analgesic drugs). Result: In total 60 patients from both the groups completed the study. In our study we found the majority (58%) of our patients were aged between 41-60 years old followed by 30% were aged above 60 years old. The least prevalence 5% &amp;7% was found among &lt;= 20 and 21-40 years old respectively. In this study we found majority of our patients were male (63%) compared to female (37%).The mean age in the group A and group B patients were 48.73 ± 14.26 years and 51.47 ± 12.35 years respectively. In our study we found after 15th day of treatment severe vomiting was 13% in group B on the other hand vomiting was absent in. 13% in group ........

Geographical Distribution of Pancreatic Cancer in the State of Mississippi by Incidence and Mortality From 2003 to 2019.

Pancreatic cancer can be a very debilitating disease. In the USA and around the world, pancreatic cancer is among the causes ofcancer-related deaths. This study aims to highlight mortality and incidence rates of pancreatic cancer by geographic location. The study area is the state of Mississippi with atargeted time period between 2003 and 2019. The Mississippi Cancer Registry is the source of data for this study. The subject under investigation was divided into two phases. The first phase involved analyzing data on the incidence rate while the second phase entailed data analysis of the pancreatic cancer mortality rate in Mississippi. In both phases, the focus was on three categories of geographic locations in Mississippi, which includepublic health districts, the regional cancer coalitions in the state, and the interplay between rural and urban locations.Descriptiveand inferential statistical approaches with graphical techniques and tabulations were utilized in data presentation. The results of this study demonstrate there are variations in the incidence rates of pancreatic cancer by geographic location in Mississippi. In the data analysis of the Mississippi public health districts, the worst-hit areas include the rural communities in the rural-urban regional analysis, the Delta region among the cancer coalition regions, and the Central District (incidence rates) and North District (mortality rates). In Mississippi, there is a need for aggressive community-based participation and education. This approach will help improve screening and early detection of pancreatic cancer. Healthcare intake should be boosted and geared toward a reduction in mortality rates. To minimize disparities that eventually lead to differences in disease incidence and mortality from different locations, legislative and non-legislative authorities should advocate for equitable distribution of healthcare resources. An understanding of the geographic distribution of pancreatic cancer in a state will aid in the designation of specific primary prevention measures targeted in the worst-hit communities.

County-Level Factors Associated with High Age-Adjusted Incidence Rates of Pancreatic Cancer in the US

County-Level Factors Associated with High Age-Adjusted Incidence Rates of Pancreatic Cancer in the US

S74 Demographic Analysis of Pancreatic Cancer Incidence Rates by Race and Gender

Introduction: Pancreatic cancer (PC) is the third-leading cause of cancer related-deaths in the US as of 2020. In recent years, there has been an increasing focus on the disparities of PC incidence. African Americans have worse overall outcomes compared to other racial groups. The stage of PC at time of diagnosis may be utilized to address this disparity. Methods: This study analyzed the stage of PC at diagnosis in males by race/ethnicity from 2015-2019 using data extracted from the National Cancer Institute Surveillance, Epidemiology, and End Results Cancer (SEER) Statistics Explorer Network. Age-adjusted incidence rates per 100,000 are categorized into localized, regional, and distant stages of cancer diagnosis and stratified by race/ethnicity. Results: For female patients, the rate of diagnosis was significantly higher for African Americans (AA) compared to other races across all stages of PC. AA females had higher incidence rates of localized, regional, and distant disease at 2.29%, 4.11%, and 6.96%, respectively [Table, Figure 1a]. In comparison, Asian/Pacific Islander (API) females had the lowest incidence rate at 1.34%, 2.78%, and 4.15%, respectively. The incidence rate per 100,000 for localized and regional PC was not significantly different between AA and Caucasian (CN) males at 2.10 and 2.18, respectively, for localized PC, at 4.44 and 4.45, respectively for regional PC [Figure1b]. Hispanic (HP) and API males had significantly lower incidence compared to AA and CN males at 1.76 and 1.58, respectively, for localized disease, and 3.13 and 3.17, respectively, for regional. Distant PC at time of diagnosis was significantly greater among AA males at 9.23%, compared to rates of 7.59% in CN males, 6.36% in HP males, and 5.11% in API males. All results p< 0.01. Conclusion: The rate of incidence for AA females is greater across all stages of PC, suggesting a genetic or socioeconomic predisposition, although further investigation is necessary. In males with PC, there is a disproportionately greater incidence of stage IV PC. With well-established increased mortality rates among AA, it is important to consider the role of access to healthcare. While multifactorial in etiology, highlighting the racial disparity in stage of PC at diagnosis emphasizes the importance of clinical suspicion. Earlier recognition should be prioritized with interventions to improve outcomes of PC in AA males.Figure 1.: SEER Age-Adjusted Incidence Rates of PC, 2015-2019 by Stage at Diagnosis and Race/Ethnicity, Female (1a) and Male (1b) Table 1. - SEER Age-Adjusted Incidence Rates (with 95% CI) of PC, 2015-2019 By Stage at Diagnosis and Race/Ethnicity, Female and Male Localized Regional Distant Female Black 2.29 (2.16-2.43) 4.11 (3.93-4.29) 6.96 (6.73-7.20) White 1.76 (1.71-1.80) 3.35 (3.28-3.41) 5.34 (5.26-5.42) Hispanic (any race) 1.74 (1.64-1.84) 3.06 (2.93-3.20) 5.09 (4.92-5.27) Asian/Pacific Islander 1.34 (1.23-1.46) 2.78 (2.61-2.95) 4.15 (3.95-4.36) Male Black 2.10 (1.94-2.26) 4.45 (4.23-4.68) 9.23 (8.91-9.56) White 2.18 (2.12-2.24) 4.44 (4.36-4.52) 7.59 (7.48-7.70) Hispanic (any race) 1.76 (1.64-1.88) 3.13 (2.98-3.28) 6.36 (6.14-6.58) Asian/Pacific Islander 1.58 (1.44-1.73) 3.17 (2.97-3.37) 5.11 (4.86-5.37)

Analysis and forecast of burden of pancreatic cancer along with attributable risk factors in Asia countries between 1990 and 2019

Objective: To analyze the disease burden of pancreatic cancer in major Asian countries and forecast the burden of that in China, which helps to provide reference for the prevention and control of pancreatic cancer. Methods: Data on disease burden of pancreatic cancer among global and major Asian countries from on the Global Burden of Disease (GBD) 2019 were collected to describe burden distribution through the absolute numbers or standardized rates of incidence, death and disability adjusted life years (DALY) by year, sex and socio-demographic index. Estimated annual percentage changes (EAPC) was used to assess the trend of standardized rate. The proportion of deaths attributable to risk factors for pancreatic cancer in 2019 was used to compare by age, sex and region. ARIMA model was performed with R language to predict change of age-standardized incidence and death rates of pancreatic cancer from 2020 to 2029. Results: From 1990 to 2019, the standardized incidence rates of pancreatic cancer in China increased from 3.17/100 000 to 5.78/100 000, and the standardized death rate increased from 3.34/100 000 to 5.99/100 000. The increases exceeded other high-income Asia countries. In the past three decades, the standardized incidence, death and DALY rates of pancreatic cancer in global have increased year by year. Among the major countries in Asia, China has the highest growth rate of disease burden (EAPC of standardized incidence rates=2.32%, 95% CI: 2.10%-2.48% and EAPC of standardized death rate=2.25%, 95% CI: 2.03%-2.42%). In addition, incidence and death rates of pancreatic cancer in China are expected to continue on the rise between 2000 and 2029 by ARIMA model. Incidence rate is expected to increase 15.92% and death rate is expected to increase 15.86%. Conclusions: The standardized incidence and death rates of pancreatic cancer in China increase year by year with an increasing trend for the burden of disease. The disease burden of pancreatic cancer is expected to rise due to the increase and aging of the population. Preventive measures should be adopted to decrease the burden of the pancreatic cancer.

Association between age at diabetes onset or diabetes duration and subsequent risk of pancreatic cancer: results from a longitudinal cohort and mendelian randomization study

The aim of the study is to estimate the incidence of pancreatic cancer among individuals with new-onset type 2 Diabetes (T2DM) and evaluate the relationship of pancreatic cancer risk with age at diabetes onset and diabetes duration. This longitudinal cohort study included 428,362 new-onset T2DM patients in Shanghai and Mendelian randomization (MR) in the east-Asian population were used to investigate the association. Incidence rates of pancreatic cancer in all patients and by subgroups were calculated and compared to the general population. A total of 1056 incident pancreatic cancer cases were identified during eight consecutive years of follow-up. The overall pancreatic cancer annual incidence rate was 55·28/100,000 person years in T2DM patients, higher than that in the general population, with a standardized incidence ratio (SIR) of 1·54 (95% confidence interval [CI], 1·45-1·64). The incidence of pancreatic cancer increased with age and a significantly higher incidence was observed in the older groups with T2DM. However, the relative pancreatic cancer risk was inversely related to age of T2DM onset, and a higher SIR of 5·73 (95%CI, 4·49-7·22) was observed in the 20-54 years old group. The risk of pancreatic cancer was elevated at any diabetes duration. Fasting blood glucose ≥10·0 mmol/L was associated with increased risk of pancreatic cancer. MR analysis indicated a positive association between T2DM and pancreatic cancer risk. Efforts toward early and close follow-up programs, especially in individuals with young-onset T2DM, and the improvement of glucose control might represent effective strategies for improving the detection and results of treatment of pancreatic cancer. Chinese National Natural Science Foundation.

Abstract 1746: Optimizing Gemcitabine efficacy through chemical modification for the treatment of pancreatic cancer using PDX mouse model

Abstract PURPOSE: Despite the remarkable advances in cancer treatment, the incidence rate of pancreatic cancer (PCa) for decades among African Americans (AA) has been 30% to 70% higher than other racial groups in the United States. Gemcitabine (Gem) remains the first-choice treatment for PCa. It is administered as monotherapy in patients with locally advanced and metastatic PCa; but, drug resistance develops over time. Gem treatment resistance coupled with poor pharmacokinetics (short half-life) has resulted in poor treatment outcomes. The purpose of this study is to enhance the anticancer efficacy and pharmacokinetic profile of Gem through chemical modification of Gem with stearic acid by using mice bearing tumors from AA and White pancreatic cancer patients. METHODS: The Gem was modified by conjugating the 4-amino group of Gem and stearoyl acyl derivative to form 4-(N)-stearoyl-gemcitabine (4NSG). 4NSG was developed into solid lipid nanoparticles (4NSG-SLN) and characterized using nuclear magnetic resonance (NMR), micro-elemental analysis, and high liquid chromatography (HPLC). Patient-derived primary pancreatic cancer cells from AA (PPCL-135 and PPCL-192) and Whites (PPCL-46 and PPCL-68) were used to evaluate the anticancer activity of Gem and 4NSG-SLN. We performed antitumor efficacy testing of Gem and 4NSG-SLN in a patient-derived xenograft (PDX) mouse model harboring pancreatic tumors from the same AA and White patients. RESULTS: The H-NMR spectra displayed an amide bond at 11ppm, confirming the conjugated bond between the 4-amino group of Gem and stearoyl derivative. The half-maximal inhibitory concentration (IC50 =12 ± 2.1µM) of 4NSG-SLN-treated PPCL-46 and (IC50 =22 ± 2.6µM) of 4NSG-SLN-treated PPCL-68 cultures were significantly higher than that of Gem treated PPCL-46 and PPCL-68 cultures respectively (IC50 = 56 ± 2.4 µM, IC50 = 57 ± 1.5 µM, p-value: p&amp;lt;0.001). We found a similar trend of higher growth inhibition of 4NSG-SLN treated PPCL-135 and PPCL-192 cultures (IC50 = 11± 1.3 µM; IC50 = 9 ± 1.1 µM) respectively, P&amp;lt; 0.001 (4NSG-SLN-PPCL-135 vs. Gem-PPCL-135) and P&amp;lt;0.001 (4NSG-SLN-PPCL-192-2 vs Gem-PPCL-192) compared with Gem treated PPCL-135 and PPCL-192 cultures (IC50 = 56 ± 1.8 µM; IC50 =57 ± 2.4 µM) respectively. The anticancer activity of 4NSG-SLN showed an enhanced efficacy in PPCL-46, PPCL-68, PPCL-135, and PPCL-192 treated cultures compared with their corresponding Gem treatments. In vivo studies, 4NSG-SLN treated mice bearing AA tumors showed significant tumor growth inhibition compared with GemHCl treated mice bearing AA tumors. A similar pattern was observed where 4NSG-SLN treated mice bearing White tumors showed significant tumor growth inhibition than GemHCl treated mice bearing White tumors. CONCLUSION: This study reveals that 4NSG-SLN may be a novel approach to significantly enhance the therapeutic efficacy of Gem in the treatment of pancreatic cancer. Citation Format: Andriana Inkoom, Edward Agyare, Nkafu Bechem Ndemazie, Taylor Smith, Bo Han, Jose Trevino Trevino. Optimizing Gemcitabine efficacy through chemical modification for the treatment of pancreatic cancer using PDX mouse model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1746.