Pancreatic cancer tumors are the third leading cause of cancer-related deaths in the United States, according to the Hirshberg Foundation for Pancreatic Cancer Research. The American Cancer Society estimates that about 67,440 people will be diagnosed with pancreatic cancer in 2025. Risk factors vary between conditions one can control, like tobacco use, weight, and exposure to certain chemicals, and ones that are entirely out of the patient’s control, like age, sex, race, family history, and inherited genetic syndromes. Recent research from the journal Cancer Research Communications showed that molecular differences have been identified between Black and white pancreatic cancer patients, which can affect how they respond to cancer treatments.
Allison Rosenzweig, PhD, Director of Scientific Research & Communications at the Pancreatic Cancer Action Network (PanCAN), explains to BlackDoctor.org that “Black Americans have the highest incidence and death rates of pancreatic cancer compared to other racial and ethnic groups. Data also shows that Black Americans have lower rates of being offered surgery and being invited to participate in clinical trials. Potential biological differences in disease development and progression among racial and ethnic groups are poorly understood, and evidence suggests that social determinants of health play a role in the issues observed. More research is needed to better understand the biological, societal, and systemic barriers that need to be broken down to achieve health equity for all people diagnosed with pancreatic cancer.”
Research shows that Black or African American patients experience high incidence and lower survival rates compared to other racial groups. Another study analyzing data from the Surveillance, Epidemiology, and End Results (SEER) program, which collects statistical cancer data across the U.S., found that the Black or African American (BAA) population exhibited a higher age-adjusted incidence rate of pancreatic cancer than white peers. The SEER data also revealed that Black patients had lower 5-year survival rates than white patients. The study also showed that the prevalence is more pronounced among females than males.
More research is needed to understand the exact reasons for the racial inconsistencies in the prevalence of pancreatic cancer tumors. Biological factors such as race-associated molecular differences may impact the way patients with this type of cancer respond to immunotherapies.
For example, a study conducted by researchers at the Henry Ford Health Pancreatic Cancer Center found that Black patients exhibited a higher prevalence of PD-L1 overexpression, which is a marker often linked with aggressive cancer behavior and a key target for immunotherapy. The study also showed that compared to white patients, Black patients showed higher frequencies of TP53 mutations and KRASG12R mutations, which are genes that affect the speed of cancer growth and the body’s ability to fight cancer. Studies on different types of cancers have identified other potential biological mechanisms contributing to disparities in human tumor development, including gene expression regulation, RNA (ribonucleic acid) processing, epigenetic modifications, and immune signaling pathways.
Access to quality health care, insurance, or medical care may also contribute to differences in diagnosis and treatment outcomes.
“Black Americans have the highest incidence and death rates of pancreatic cancer compared to other racial and ethnic groups. Data also show that Black Americans have lower rates of being offered surgery and being invited to participate in clinical trials,” Dr. Rosenzweig adds. Recent research findings support the idea that clinical trials need to enroll patients from different racial groups to better understand how tumor molecular changes and differences affect immunotherapies and other popular treatment approaches.
Rosenzweig notes that pancreatic cancer highly affects the Black American community, but Black Americans (and Hispanic/Latinx Americans) are underrepresented in pancreatic cancer clinical trials. “[Increased Black] pancreatic cancer clinical trial participation will allow broader access to new and potentially more effective treatment options and will provide data on the efficacy of investigational treatments on a diverse group of patients that better represents the people who get the disease,” Rosenzweig adds.
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