Dana B Cardin, MD, MSCI, Associate Professor of Medicine in the Division of Hematology/Oncology at Vanderbilt University Medical Center. In this audio, she speaks about the Trends in the Incidence and Treatment of Early-Onset Pancreatic Cancer.
Early-onset pancreatic cancer (EOPC) is uncommon. It is unknown if the incidence of EOPC is increasing or how these patients are being treated.
We used SEER 2004-2016 to conduct a retrospective population-based investigation. We looked at the annual age-adjusted incidence rate (AAIR), stage at presentation, and race/ethnicity of 7802 patients, as well as treatment patterns in 7307 patients (excluding neuroendocrine tumors) under the age of 50.
Males had a greater AAIR, but females rose at a faster rate. The AAIR was highest in non-Hispanic Black patients and rose over time for all races/ethnicities. The percentage of patients diagnosed with distant-stage disease declined over time, while the percentage of patients diagnosed with localized-stage disease grew. Hispanic patients made up a higher proportion of patients throughout time than other groups. Primary surgery was the most commonly used technique of treatment for localized-stage illness. Chemotherapy with radiation was the most commonly used treatment for regional-stage cancer from 2004 to 2010, but chemotherapy alone was the most commonly used treatment from 2011 to 2016. Chemotherapy alone was the most commonly used treatment for advanced disease, and it has been used more frequently over time. Patients with EOPC got radiation and chemotherapy at comparable rates and had surgery more frequently than patients aged 50 to 69.
The AAIR of EOPC rose throughout time, more notably in females. Groups with a higher burden of pancreatic cancer, particularly African Americans, had a higher burden of EOPC. The treatment of localized and regional-stage pancreatic cancer did not follow standard pancreatic cancer therapy guidelines. Our findings suggest that EOPC patients received more treatment than their older counterparts.