A retrospective analysis of incidence trends, socio-demographic, and clinical characteristics in adolescents and young adults with pancreatic cancer in the United States using the SEER Database, 2004-2015 Open Access

Renfroe, Meredith (Fall 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/nc580n637?locale=en
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Abstract

Background: Pancreatic cancer is one of the deadliest malignant neoplasms worldwide. Ageadjusted incidence has increased from 11.85 per 100,000 in 2000 to 14.7 per 100,000 in 2014. Similarly, the cancer incidence of adolescents and young adults (AYA) for all sites is also increasing. Despite the vulnerable nature of young cancer patients, research on AYAs with pancreatic cancer is limited. The purpose of this descriptive study was to determine trends in incidence as well as compare demographics, stage at presentation, treatment patterns, and survival with older individuals between 2004 and 2015.

Methods: Publicly available data was obtained from the Surveillance, Epidemiology, and End Results (SEER) Database. SEER*Stat was used to calculate incidence rates and trends, percent change, annual percentage change, and survival statistics of AYA with pancreatic cancer. Distributions of age, sex, marital status, race, and median household income were also generated for all cases. Chi square analyses were used to conduct descriptive statistics between age groups (15-39 vs 40+).

Results: The incidence rate of pancreatic cancer in AYA has not increased significantly since 2004 (0.358 per 100,000 in 2004, 0.426 per 100,000 in 2015). Significant differences in race, marital status, stage at diagnosis, and treatment were present between age groups (p<0.0001). AYA had higher cause-specific survival rates than older individuals. Notable gains in causes pecific survival rates were seen in this population over time, specifically those with advanced disease.

Conclusions: Prospective research on this population is needed to determine possible differences in tumor biology as well as those at increased risk for decreased health-related quality of life.

Table of Contents

Chapter I: Introduction .......................................................................... 1

Problem Statement ................................................................................ 1

Theoretical Framework .......................................................................... 2

Purpose Statement ................................................................................. 2

Hypotheses ............................................................................................. 2

Significance Statement ............................................................................ 3

Definition of Terms .................................................................................. 4

Chapter 2: Review of the Literature ......................................................... 6

Incidence ................................................................................................... 7

Socio-demographics in AYA compared to Older Patients ......................... 8

Clinical Characteristics in AYA compared to Older Patients ....................... 8

Staging ........................................................................................................ 8

Treatment ................................................................................................... 9

Survival ........................................................................................................ 9

Summary of Literature ................................................................................ 11

Chapter 3: Methodology ............................................................................... 11

Introduction .................................................................................................. 11

Chapter 4: Results ........................................................................................ 13

Key Findings ................................................................................................... 13

Incidence ........................................................................................................ 13

Socio-demographics in AYA compared to Older Patients ............................... 13

Clinical Characteristics and Outcomes in AYA compared to Older Patients ...... 13

Other findings ..................................................................................................... 14

Chapter 5: Conclusions, Implications and Recommendations ........................... 15

Summary of Study ................................................................................................. 15

Discussion of Key Results ...................................................................................... 15

Limitations ............................................................................................................. 17

Implications ............................................................................................................. 18

Recommendations and Conclusion .......................................................................... 18

References ................................................................................................................ 20

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