OBJECTIVES: African Americans (AAs) have disproportionately higher incidence and lower survival rates from pancreatic cancer compared with whites. Historically, this disparity has been attributed to modifiable risk factors. Recent studies suggest that nonmodifiable aspects may also play an important role. We review these new contributions as potential targets for closing the disparity. METHODS: A PubMed search was conducted to review studies of nonmodifiable elements contributing to pancreatic cancer disparities in AAs. RESULTS: Several nonmodifiable risks are associated with the racial disparity in pancreatic cancer. SSTR5 P335L, Kaiso, and KDM4/JMJD2A demonstrate differential racial expression, increasing their potential as therapeutic targets. Many social determinants of health and their associations with diabetes, obesity, and the microbiome are partially modifiable risk factors that significantly contribute to outcomes in minorities. Barriers to progress include the low minority inclusion in research studies. CONCLUSIONS: Genomics, epigenetics, the microbiome, and social determinants of health are components that contribute to the pancreatic cancer disparity in AAs. These factors can be researched, targeted, and modified to improve mortality rates. Closing the disparity in pancreatic cancer will require an integrated approach of personalized medicine, increased minority recruitment to studies, and advanced health care/education access.
OBJECTIVES: African Americans (AAs) have disproportionately higher incidence and lower survival rates from pancreatic cancer compared with whites. Historically, this disparity has been attributed to modifiable risk factors. Recent studies suggest that nonmodifiable aspects may also play an important role. We review these new contributions as potential targets for closing the disparity. METHODS: A PubMed search was conducted to review studies of nonmodifiable elements contributing to pancreatic cancer disparities in AAs. RESULTS: Several nonmodifiable risks are associated with the racial disparity in pancreatic cancer. SSTR5P335L, Kaiso, and KDM4/JMJD2A demonstrate differential racial expression, increasing their potential as therapeutic targets. Many social determinants of health and their associations with diabetes, obesity, and the microbiome are partially modifiable risk factors that significantly contribute to outcomes in minorities. Barriers to progress include the low minority inclusion in research studies. CONCLUSIONS: Genomics, epigenetics, the microbiome, and social determinants of health are components that contribute to the pancreatic cancer disparity in AAs. These factors can be researched, targeted, and modified to improve mortality rates. Closing the disparity in pancreatic cancer will require an integrated approach of personalized medicine, increased minority recruitment to studies, and advanced health care/education access.
Authors: Alexander S Thomas; Rahul K Sharma; Wooil Kwon; Kazuki N Sugahara; John A Chabot; Beth A Schrope; Michael D Kluger Journal: J Gastrointest Surg Date: 2022-05-02 Impact factor: 3.267
Authors: 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 Journal: Cancer Med Date: 2019-05-09 Impact factor: 4.452
Authors: Ekene Emmanuel Nweke; Previn Naicker; Shaun Aron; Stoyan Stoychev; John Devar; David L Tabb; Jones Omoshoro-Jones; Martin Smith; Geoffrey Candy Journal: PLoS One Date: 2020-10-13 Impact factor: 3.240
Authors: Valentina A Zavala; Paige M Bracci; John M Carethers; Luis Carvajal-Carmona; Nicole B Coggins; Marcia R Cruz-Correa; Melissa Davis; Adam J de Smith; Julie Dutil; Jane C Figueiredo; Rena Fox; Kristi D Graves; Scarlett Lin Gomez; Andrea Llera; Susan L Neuhausen; Lisa Newman; Tung Nguyen; Julie R Palmer; Nynikka R Palmer; Eliseo J Pérez-Stable; Sorbarikor Piawah; Erik J Rodriquez; María Carolina Sanabria-Salas; Stephanie L Schmit; Silvia J Serrano-Gomez; Mariana C Stern; Jeffrey Weitzel; Jun J Yang; Jovanny Zabaleta; Elad Ziv; Laura Fejerman Journal: Br J Cancer Date: 2020-09-09 Impact factor: 9.075