Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities
Abstract Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle‐wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and...
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2019-06-01
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Online Access: | https://doi.org/10.1002/cam4.2180 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jennifer B. Permuth Ashley Clark Daly Daniel Jeong Jung W. Choi Miles E. Cameron Dung‐Tsa Chen Jamie K. Teer Tracey E. Barnett Jiannong Li Benjamin D. Powers Nagalakshmi B. Kumar Thomas J. George Karla N. Ali Tri Huynh Shraddha Vyas Clement K. Gwede Vani N. Simmons Pamela J. Hodul Estrella M. Carballido Andrew R. Judge Jason B. Fleming Nipun Merchant Jose G. Trevino |
spellingShingle |
Jennifer B. Permuth Ashley Clark Daly Daniel Jeong Jung W. Choi Miles E. Cameron Dung‐Tsa Chen Jamie K. Teer Tracey E. Barnett Jiannong Li Benjamin D. Powers Nagalakshmi B. Kumar Thomas J. George Karla N. Ali Tri Huynh Shraddha Vyas Clement K. Gwede Vani N. Simmons Pamela J. Hodul Estrella M. Carballido Andrew R. Judge Jason B. Fleming Nipun Merchant Jose G. Trevino Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities Cancer Medicine cachexia biomarkers incidence mortality pancreatic cancer racial disparities |
author_facet |
Jennifer B. Permuth Ashley Clark Daly Daniel Jeong Jung W. Choi Miles E. Cameron Dung‐Tsa Chen Jamie K. Teer Tracey E. Barnett Jiannong Li Benjamin D. Powers Nagalakshmi B. Kumar Thomas J. George Karla N. Ali Tri Huynh Shraddha Vyas Clement K. Gwede Vani N. Simmons Pamela J. Hodul Estrella M. Carballido Andrew R. Judge Jason B. Fleming Nipun Merchant Jose G. Trevino |
author_sort |
Jennifer B. Permuth |
title |
Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
title_short |
Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
title_full |
Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
title_fullStr |
Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
title_full_unstemmed |
Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
title_sort |
racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequities |
publisher |
Wiley |
series |
Cancer Medicine |
issn |
2045-7634 |
publishDate |
2019-06-01 |
description |
Abstract Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle‐wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and mortality rates may be highest among Black Floridians and the secondary hypothesis that biological correlates of cancer cachexia may underlie disparities. PC incidence and mortality rates were estimated by race/ethnicity, gender, and county using publicly available state‐wide cancer registry data that included approximately 2700 Black, 25 200 Non‐Hispanic White (NHW), and 3300 Hispanic/Latino (H/L) Floridians diagnosed between 2004 and 2014. Blacks within Florida experienced a significantly (P < 0.05) higher incidence (12.5/100 000) and mortality (10.97/100 000) compared to NHW (incidence = 11.2/100 000; mortality = 10.3/100 000) and H/L (incidence = 9.6/100 000; mortality = 8.7/100 000), especially in rural counties. To investigate radiologic and blood‐based correlates of cachexia, we leveraged data from a subset of patients evaluated at two geographically distinct Florida Cancer Centers. In Blacks compared to NHW matched on stage, markers of PC‐induced cachexia were more frequent and included greater decreases in core musculature compared to corresponding healthy control patients (25.0% vs 10.1% lower), greater decreases in psoas musculature over time (10.5% vs 4.8% loss), lower baseline serum albumin levels (3.8 vs 4.0 gm/dL), and higher platelet counts (332.8 vs 268.7 k/UL). Together, these findings suggest for the first time that PC and cachexia may affect Blacks disproportionately. Given its nearly universal contribution to illness and PC‐related deaths, the early diagnosis and treatment of cachexia may represent an avenue to improve health equity, quality of life, and survival. |
topic |
cachexia biomarkers incidence mortality pancreatic cancer racial disparities |
url |
https://doi.org/10.1002/cam4.2180 |
work_keys_str_mv |
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doaj-4f5fe1ef9f3f497e9b3028594501715a2020-11-25T00:23:24ZengWileyCancer Medicine2045-76342019-06-01863314332410.1002/cam4.2180Racial and ethnic disparities in a state‐wide registry of patients with pancreatic cancer and an exploratory investigation of cancer cachexia as a contributor to observed inequitiesJennifer B. Permuth0Ashley Clark Daly1Daniel Jeong2Jung W. Choi3Miles E. Cameron4Dung‐Tsa Chen5Jamie K. Teer6Tracey E. Barnett7Jiannong Li8Benjamin D. Powers9Nagalakshmi B. Kumar10Thomas J. George11Karla N. Ali12Tri Huynh13Shraddha Vyas14Clement K. Gwede15Vani N. Simmons16Pamela J. Hodul17Estrella M. Carballido18Andrew R. Judge19Jason B. Fleming20Nipun Merchant21Jose G. Trevino22Department of Cancer Epidemiology Moffitt Cancer Center Tampa FloridaDivision of Behavioral Health Idaho Department of Health and Welfare Boise IdahoDepartment of Diagnostic Radiology Moffitt Cancer Center Tampa FloridaDepartment of Cancer Imaging & Metabolism Moffitt Cancer Center Tampa FloridaDepartment of Surgery, Division of General Surgery University of Florida Health Sciences Center Gainesville FloridaDepartment of Biostatistics and Bioinformatics Moffitt Cancer Center Tampa FloridaDepartment of Biostatistics and Bioinformatics Moffitt Cancer Center Tampa FloridaSchool of Public Health University of North Texas Health Science Center Fort Worth TexasDepartment of Biostatistics and Bioinformatics Moffitt Cancer Center Tampa FloridaDepartment of Gastrointestinal Oncology Moffitt Cancer Center Tampa FloridaDepartment of Cancer Epidemiology Moffitt Cancer Center Tampa FloridaDepartment of Medicine University of Florida Health Sciences Center Gainesville FloridaDepartment of Cancer Epidemiology Moffitt Cancer Center Tampa FloridaDepartment of Cancer Epidemiology Moffitt Cancer Center Tampa FloridaDepartment of Cancer Epidemiology Moffitt Cancer Center Tampa FloridaDepartment of Health Outcomes and Behavior Moffitt Cancer Center Tampa FloridaDepartment of Health Outcomes and Behavior Moffitt Cancer Center Tampa FloridaDepartment of Gastrointestinal Oncology Moffitt Cancer Center Tampa FloridaDepartment of Gastrointestinal Oncology Moffitt Cancer Center Tampa FloridaDepartment of Physical Therapy University of Florida Gainesville FloridaDepartment of Gastrointestinal Oncology Moffitt Cancer Center Tampa FloridaDepartment of Surgical Oncology, Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami FloridaDepartment of Surgery, Division of General Surgery University of Florida Health Sciences Center Gainesville FloridaAbstract Pancreatic cancer (PC) is characterized by racial/ethnic disparities and the debilitating muscle‐wasting condition, cancer cachexia. Florida ranks second in the number of PC deaths and has a large and understudied minority population. We examined the primary hypothesis that PC incidence and mortality rates may be highest among Black Floridians and the secondary hypothesis that biological correlates of cancer cachexia may underlie disparities. PC incidence and mortality rates were estimated by race/ethnicity, gender, and county using publicly available state‐wide cancer registry data that included approximately 2700 Black, 25 200 Non‐Hispanic White (NHW), and 3300 Hispanic/Latino (H/L) Floridians diagnosed between 2004 and 2014. Blacks within Florida experienced a significantly (P < 0.05) higher incidence (12.5/100 000) and mortality (10.97/100 000) compared to NHW (incidence = 11.2/100 000; mortality = 10.3/100 000) and H/L (incidence = 9.6/100 000; mortality = 8.7/100 000), especially in rural counties. To investigate radiologic and blood‐based correlates of cachexia, we leveraged data from a subset of patients evaluated at two geographically distinct Florida Cancer Centers. In Blacks compared to NHW matched on stage, markers of PC‐induced cachexia were more frequent and included greater decreases in core musculature compared to corresponding healthy control patients (25.0% vs 10.1% lower), greater decreases in psoas musculature over time (10.5% vs 4.8% loss), lower baseline serum albumin levels (3.8 vs 4.0 gm/dL), and higher platelet counts (332.8 vs 268.7 k/UL). Together, these findings suggest for the first time that PC and cachexia may affect Blacks disproportionately. Given its nearly universal contribution to illness and PC‐related deaths, the early diagnosis and treatment of cachexia may represent an avenue to improve health equity, quality of life, and survival.https://doi.org/10.1002/cam4.2180cachexiabiomarkersincidencemortalitypancreatic cancerracial disparities |