A new Yale-led study published in JNCI Cancer Spectrum is the first to examine the overall relationship between pancreatic cancer and neighborhood-level socioeconomic factors.
Pancreatic cancer is an aggressive disease that often remains silent, leading to diagnoses at later stages when it is more difficult to treat. Although there have been recent treatment advances, researchers still have many questions about why pancreatic cancer develops and how to screen for it.
“For some common cancers, a person’s neighborhood is correlated with their likelihood of developing the disease,” says Louise Wang, MD, assistant professor of medicine (digestive diseases) at Yale School of Medicine and senior author of the study. “We wanted to understand if this holds true for pancreatic cancer. Are individual-level risk factors, like genetics and lifestyle, the most significant, or do neighborhood-level factors play a role in the development of this cancer?”
The researchers used Veterans Health Administration (VA) area deprivation index data, which measures neighborhood disadvantage across categories such as income, education, housing quality, and other factors. They identified 31,242 veterans diagnosed with the most common form of pancreatic cancer who also had area deprivation index data available.
The study found that veterans living in neighborhoods with the highest level of advantage had a slightly increased risk of being diagnosed with pancreatic cancer. This was true even when accounting for clinical and lifestyle risk factors for pancreatic cancer.
“We were not expecting to see that individuals living in neighborhoods with higher incomes, education levels, and other forms of advantage would have increased risk of pancreatic cancer,” says Wang. “It’s possible that in those neighborhoods there is increased screening and surveillance, so people are diagnosed at a higher rate.”
Wang notes that the risk level was still very minimal compared to other individual-level risk factors, like smoking and alcohol use. Additionally, individuals in the most advantaged neighborhoods were slightly older, which may have played a role, though the study adjusted for age and factors related to mortality. She also hopes that future research will explore whether other health systems show similar results.