Association between Environmental Quality Index and metastatic pancreatic cancer.

Authors

Muhammet Ozer

Muhammet Ozer

Capital Health Regional Medical Center, Trenton, NJ

Muhammet Ozer , Suleyman Yasin Goksu , Jude Khatib , Salwan Al Mutar , Todd Anthony Aguilera , Herbert Zeh III, Muhammad Shaalan Beg , Syed Mohammad Ali Kazmi

Organizations

Capital Health Regional Medical Center, Trenton, NJ, University of Texas Southwestern Medical Center, Dallas, TX, University of Texas Southwestern Medical Center, Dallas, PA

Research Funding

No funding received

Background: Pancreatic cancer ranks as the 3rd leading cause of cancer mortality. Overall more than 50% of patients have metastatic disease at diagnosis. In this study, we evaluated the association between the national level Environmental Quality Index (EQI) and metastatic pancreatic cancer in the US. Methods: Adult patients with pancreatic cancer in the SEER database from 2010-2016 were included in this study. The unknown stage was excluded. Patients were categorized into two groups: metastatic vs. non-metastatic disease. EQI provides county-level environmental quality data from 2005-2010 and presents five domains (built, sociodemographic, air, water, land). EQI was categorized into quintiles, with the 5th quantile representing a poorer environmental quality. We used the multivariable logistic regression analysis to assess the association between EQI quintiles and metastatic pancreatic cancer adjusting by age, gender, and race (White, Black, and Others). In addition, the SEER*Stat was used to evaluate the age-adjusted incidence rate, and the correlation coefficient between EQI domains and incidence rate was calculated. Results: A total of 75,461 pancreatic cancer patients were included; 55% had metastatic disease. In the adjusted multivariable analysis, metastatic pancreatic cancer was associated with poor built EQI (OR 1.06 [1.01-1.11]). Among metastatic pancreatic cancer patients, poor overall EQI was strongly associated with age > 50 years (OR 1.06 [1.01-1.11]) and Black race (OR 1.29 [1.10-1.51]). Lower built EQI domain was associated with > 50 (OR 1.07 [1.02-1.12]) and White race (OR 1.07 [1.02-1.12]). The incidence rate of metastatic pancreatic cancer was positively correlated with total EQI (rho=0.02, p<0.001), sociodemographic EQI (rho=0.23, p<0.001), land EQI (rho=0.14, p<0.001), and air EQI (rho=0.34, p<0.001). Conclusions: Using population-based environmental data, we found built EQI to be associated with metastatic pancreatic cancer. Among metastatic pancreatic cancer patients, total environmental quality was associated with older age at diagnosis and the Black race, while built EQI domain was associated with older age at diagnosis and the White race. Environmental quality was positively correlated with the incidence rate of metastatic pancreatic cancer.

Multivariable analysis for the association between 5th quintile of EQI total/domains and metastatic pancreatic cancer.

Factors
Odds
Lower
Upper
p-value
5th EQI Total vs. 1st EQI Total (Ref)
1.045
0.998
1.094
0.059
5th Sociodemographic quintile vs. 1st Sociodemographic quintile (Ref)
1.025
0.981
1.071
0.269
5th Built quintile vs. 1st Built quintile (Ref)
1.057
1.010
1.106
0.018
5th Air quintile vs. 1st Air quintile (Ref)
1.005
0.960
1.053
0.832
5th Land quintile vs. 1st Land quintile (Ref)
1.032
0.987
1.080
0.168
5th Water quintile vs. 1st Water quintile (Ref)
1.047
0.998
1.098
0.060

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Cancer Disparities

DOI

10.1200/JCO.2022.40.4_suppl.521

Abstract #

521

Poster Bd #

E6

Abstract Disclosures

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