{
  "abstract": "Background Racial disparities in pancreatic cancer outcomes remain incompletely explained. Using a large population-based dataset, we quantified racial differences in overall and cancer-specific survival and evaluated potential mediators, including surgical access, timeliness of treatment, and area-level socioeconomic status.Methods We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database, which covers approximately 48% of the US population. We included adults with malignant pancreatic neoplasms (ICD-O-3 C25.0–C25.9) and excluded patients with unknown race (n=503) or missing survival data. Race was classified as White, Black, or Other. The co-primary outcomes were overall survival (OS) and cancer-specific survival (CSS). Results The cohort comprised 162,783 patients (White 130,374 [80.1%], Black 18,858 [11.6%], Other 13,551 [8.3%]). Median OS was 6 months (White), 5 months (Black), and 6 months (Other); 5-year OS was 8.8%, 8.2%, and 10.7%, respectively (P<0.001) ( IDDF2026-ABS-0336 Figure 1. Kaplan-Meier survival curves for overall survival (A) and cancer-specific survival (B) by race. All pairwise log-rank comparisons were significant at P < 0.001. Black patients demonstrated the worst survival for both endpoints; the Other race group (predominantly Asian/Pacific Islander) demonstrated the best outcomes). In adjusted Cox models, Black race remained associated with worse OS (HR 1.097; 95% CI 1.079–1.115) and CSS (HR 1.064; 95% CI 1.046–1.083) versus White, while Other race showed improved survival (IDDF2026-ABS-0336 Figure 2. Forest plots of adjusted hazard ratios from multivariate Cox regression for overall survival (left) and cancer-specific survival (right). Colour coding indicates risk direction: red, high risk (HR > 1.5); blue, moderate risk; green, protective; purple, surgical resection; grey, non-significant. Surgery conferred the strongest protective effect (HR, 0.30); Stage IV disease was associated with the highest risk (HR, 2.37)). After matching (18,858 pairs), Black race remained associated with worse OS (HR 1.158; 95% CI 1.131–1.185) and CSS (HR 1.121; 95% CI 1.094–1.148). Black patients had lower surgical receipt (13.9% vs 16.6% in White) and lower adjusted odds of surgery (OR 0.717; 95% CI 0.684–0.752).Conclusions In the SEER database, Black patients with pancreatic cancer experienced persistently worse OS and CSS compared with White patients, only partly explained by lower surgical receipt and socioeconomic differences.Abstract IDDF2026-ABS-0336 Figure 1Abstract IDDF2026-ABS-0336 Figure 2",
  "authors": [
    {
      "affiliations": [
        "Dow University of Health Sciences, Pakistan"
      ],
      "name": "Muhammad Asad"
    },
    {
      "affiliations": [
        "Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom"
      ],
      "name": "Arkadeep Dhali"
    },
    {
      "affiliations": [
        "School of Medicine, University of Nottingham, United Kingdom"
      ],
      "name": "Saikat Mandal"
    }
  ],
  "title": "IDDF2026-ABS-0336 Racial disparities in pancreatic cancer: a comprehensive population-based analysis of survival, surgical access, and prognostic factors",
  "uid": "bf6989e1-3dc2-56ac-986e-e81bfbc3197e"
}