Abstract A138: The Association between Food Swamps and Pancreatic Cancer Mortality in Georgia
Malcolm Bevel, Jabrena Marshall, Victoria Ayodele, Arianna Iribhogbe, Meng-Han Tsai, Samantha R. Jones, Justin X. MooreAbstract
Purpose:
We investigated the association between food swamps and pancreatic cancer mortality in Georgia counties over a ten-year span.
Background:
Pancreatic cancer is the 4th leading cause of cancer death in the state of Georgia. As one of 13 obesity-related cancers, consumption of a healthy diet with emphasis on fresh produce is a vital protective factor against pancreatic cancer is. Living in areas where unhealthy food outlets outnumber healthy food retailers (i.e., food swamps) reduces access to healthy foods, potentially leading to worse cancer outcomes. However, the association between food swamps and pancreatic cancer mortality remains understudied.
Method
ology: We conducted a cross-sectional ecological study by linking county-level pancreatic cancer mortality data (2010-2020) from the Centers for Disease Control and Prevention (CDC) WONDER with food environment data (2012 – 2020) from the United States Department of Agriculture (USDA). Food swamp scores was the exposure of interest and was defined as the ratio of fast-food and convenience stores to grocery stores and farmer’s markets. Food swamp scores then categorized as low or high, with higher scores indicating counties with poorer healthy food resources. Pancreatic cancer mortality rates (outcome of interest) were based on underlying cause of death (UCD) ICD-10 codes, and were categorized as low vs. high. Multivariable-adjusted, multilevel generalized mixed-effects models were used to estimate the aforementioned association among eligible Georgia counties (N = 94).
Results:
Compared with counties with low pancreatic cancer mortality, counties with high pancreatic cancer mortality had a higher proportion of non-Hispanic (NH)-Black residents (28.7% vs. 20.0%), higher poverty rates (20.2% vs. 13.6%), higher adult smoking rates (18.9% vs. 16.7%), and higher food swamp scores (8.11 vs. 6.92) (p-value < 0.0001). After adjusting for age, race, poverty rates, and physician density, the odds of Georgia counties with high food swamp scores had more than two-fold higher odds of high pancreatic cancer mortality than counties with low food swamp scores (AOR = 2.63; 95% CI =1.02–6.77).
Conclusion:
Georgia counties with high food swamp scores had significantly higher odds of high pancreatic cancer mortality. These findings highlight the need for scalable interventions that improve healthy food access, including community gardens and controlled-environment agriculture initiatives such as rooftop gardens, alongside nutrition education and policy efforts to reduce disparities in pancreatic cancer mortality across Georgia.
Citation Format:
Malcolm Bevel, Jabrena Marshall, Victoria Ayodele, Arianna Iribhogbe, Meng-Han Tsai, Samantha R. Jones, Justin X. Moore. The Association between Food Swamps and Pancreatic Cancer Mortality in Georgia [abstract]. In: Proceedings of the AACR Conference on Pancreatic Cancer: New Frontiers in Biology and Therapeutic Development; 2026 Sep 25-28; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(18_Suppl_2):Abstract nr A138.