Survival Advantage of Non-hispanic White Patients with Pancreatic Head Carcinoma: A Population-based Study

Numerous studies have shown that racial health disparities in gastroenterology and hepatology, but little is known about its effect on pancreatic head carcinoma (PHC). The aim of the present study was to determine whether racial disparities in the overall survival (OS) and cancer-specific survival (CSS) rates exist among US patients with PHC. The SEER database was searched for US residents who had been diagnosed with PHC from 2007 to 2015. The outcomes for 9724 Hispanic white (HW) patients and their non-Hispanic white (NHW) counterparts were compared using Kaplan-Meier survival and Cox regression analyses. We found that race affected both OS and CSS. The 5-year OS rate was worse for HW patients (45.9%) than for NHW patients (49.6%, P<0.001), as was the 5-year CSS rate (39.8% versus 44.0%, P=0.002). Race appeared to be an independent prognostic factor for PHC in the multivariate analysis, with NHW patients showing superior OS (P=0.007) and CSS (P=0.037) compared with HW patients. Subgroup analysis showed that race influenced survival among patients who received surgery, enjoyed Medicaid, and those at American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) stage II, but not of patients at AJCC TNM stage I, III, or IV and those who did not receive surgery or had no insurance. In short, the survival outcomes for PHC are better for NHW than HW patients. The survival advantage is more skewed towards NHW patients than HW patients with PHC, so culturally appropriate interventions, strengthened preventive services, and additional financial support should focus more on HWs.