According to the American Cancer Society, an estimated 62,210 new cases of pancreatic cancer will be diagnosed in the U.S. in 2022 — approximately 3% of all new cancer cases. In the U.S., pancreatic cancer is the third leading cause of cancer mortality. Overall, more than 50% of patients have metastatic disease at diagnosis due in part to pancreatic cancer being asymptomatic, hence diagnosed in its later stages.
To date, limited research has been conducted on the effect of environmental quality on metastatic pancreatic cancer. A recently study, “Association Between Environmental Quality Index and Metastatic Pancreatic Cancer,” published in the ASCO Journal of Clinical Oncology, evaluated the association between the national level Environmental Quality Index (EQI) and metastatic pancreatic cancer in the U.S.
Representing Capital Health Regional Medical Center, Trenton, NJ and the University of Texas Southwestern Medical Center, Dallas, TX, the study was a collaboration between Muhammet Ozer, Suleyman Yasin Goksu, Jude Khatib, Salwan Al Mutar, Todd Anthony Aguilera, Herbert Zeh, Muhammad Shaalan Beg, and Syed Mohammad Ali Kazmi.
Adult patients with pancreatic cancer identified in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) cancer database from 2010 to 2016 were evaluated. Patients were categorized into two groups: metastatic vs. non-metastatic disease.
Data from the Environmental Quality Index (EQI) was also used. EQI data enables researchers to study environmental effects on human health. It can provide a better understanding of how health outcomes relate to cumulative environmental exposures that are typically are viewed in isolation. EQI provides county-level environmental quality data from 2005-2010 and for five domains (built, sociodemographic, air, water, land). EQI was categorized into quintiles, with the 5th quantile representing a poorer environmental quality.
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 and Black race. The incidence rate of metastatic pancreatic cancer was positively correlated with total EQI, sociodemographic EQI, land EQI, and air EQI.
In conclusion, using population-based environmental data found built EQI to be associated with metastatic pancreatic cancer. In addition, environmental quality was found to be positively correlated with incidence rate of metastatic pancreatic cancer.