Sociodemographic disparities in survival outcomes among adolescent and young adult patients with pancreatic cancer: Insights from a SEER database analysis.

Abstract

e16422 Background: Pancreatic cancer in adolescent and young adult (AYA) patients is rare and understudied. Disparities in survival outcomes based on demographic and clinical factors in this population remain poorly understood. This study evaluates survival outcomes and their association with race, gender, stage at diagnosis, and geographic region within a cohort of AYA pancreatic cancer patients. Methods: A retrospective cohort of 2,260 AYA patients (ages 18–39) diagnosed with pancreatic cancer was analyzed. Survival outcomes were assessed using Kaplan-Meier survival analysis and Cox proportional hazards regression to examine the effects of race (American Indian, Asian, Black, White), gender, stage at diagnosis (localized, regional, distant), and geographic region (metropolitan vs. nonmetropolitan). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated to evaluate the impact of these variables on survival, statistical significance was set at P < .05. The median follow-up time was 60 months. Results: The study population comprised of 1,218 females (53.9%) and 1,042 males (46.1%), with a racial distribution of 1,665 White (73.7%), 305 Black (13.5%), 601 Asian (11.8%), and 24 American Indian (1.0%) patients. Males had a higher risk of death compared to females (HR = 1.45; 95% CI: 1.28–1.64; p < 0.001). Patients in metropolitan areas (n = 2059) had longer median survival (60 months) compared to nonmetropolitan regions (n = 201, median survival = 24 months; p = 0.003). Those with metastatic disease had significantly poorer survival (HR: 17.86; 95% CI: 13.70-23.26, p < .001) compared to patients with localized disease. Racial differences in survival were modest ( p = 0.014), with Asian patients showing the highest mean survival (38.4 months) and American Indian patients the lowest (29.9 months). Conclusions: This study demonstrates significant survival disparities among AYA pancreatic cancer patients, with outcomes influenced by stage at diagnosis, gender, race, and geographic region. The findings highlight the importance for targeted interventions to improve outcomes for at-risk groups, including male patients, those with late-stage disease, and individuals in non-metropolitan regions.