Factors Associated With Early‐Stage Pancreatic Cancer: An Analysis of the West Virginia Cancer Registry
Melissa M. Elder, Christa L. Lilly, Courtney Pilkerton, Danielle M. Davidov, Toni Marie RudisillABSTRACT
Background
There are limited studies examining factors such as rurality, age, gender, and race, associated with early‐stage pancreatic cancer (PC) using population‐based data from Appalachia.
Methods
A cross‐sectional study was conducted using patients treated for PC from 1993 to March 2023 and documented in the West Virginia Cancer Registry. Factors associated with early versus late diagnostic stage, including rurality, age, race, gender, and tumor location were analyzed using multivariable logistic regression models.
Results
Among 4687 individuals meeting inclusion criteria, 30% were diagnosed with early‐stage PC. The majority lived in non‐rural counties at time of diagnosis. Most patients did not receive surgery (82%), radiation (89%), chemotherapy (52%), nor immunotherapy (99%) as part of the first course of treatment. Among all cases (n = 7815), 41% received no treatments. Radiation was performed more frequently with early‐stage diagnosis (15.6% versus 9.1%, p < 0.0001). Several factors were associated with increased odds of early‐stage diagnosis including age (aOR = 1.20; 95% CI 1.05, 1.36) and head of the pancreas as the primary tumor site (aOR = 2.25; 95% CI 1.95, 2.60). Males were at decreased odds of early‐stage diagnosis (aOR = 0.85; 95% CI 0.74, 0.98). There were no statistically significant associations between the diagnosis of early‐stage disease and rurality (aOR = 0.94; 95% CI 0.76, 1.16).
Conclusion
Numerous patients did not receive standard treatment modalities as first course of treatment. Older adults were more likely to be diagnosed with early‐stage disease questioning underlying motivators for seeking care. Findings may inform diagnoses of early‐stage PC in West Virginia.