HOW GOOD IS THE NEIGHBORHOOD? RACIAL DISPARITIES IN RESOURCE AVAILABILITY FOR PANCREATIC NEUROENDOCRINE TUMOR PATIENTS
Katherine McElroy*, Rui Zheng-Pywell, Chandler McLeod, Ahmer Irfan, Sushanth Reddy, Herbert Chen, J. Bart Rose
UAB Hospital, Birmingham, AL
Introduction
Disparities in pancreatic neuroendocrine tumors (pNETs) exist at a patient, provider, and health system level. Tumor biology, tumor microenvironment, and patient socioeconomic determinants of health have been shown to contribute role to this observed discrepancy at the patient level. Area deprivation index (ADI) is a geospatial indicator of relative socioeconomic deprivation comprised of seventeen neighborhood-level indications on a national scale of 1-100. Our study aims to evaluate how resource availability per patient impacts survival in pNET patients.
Methods
A retrospective chart review was conducted of patients with pancreatic neuroendocrine tumors resected between March 2010-2019. Clinicopathologic characteristics were used to evaluate independent and interactive associations with area of deprivation index. National ADI was divided into low and high ADI groups by median. Independent t-tests and analysis of variance tests were utilized to determine relationship between group means. Chi-squared tests were utilized to determine relationship between categorial variables. Kaplan-Meier survival analyses were constructed to determine disease free survival (DFS) of ADI between racial groups. All analyses were performed within SPSS with statistical significance defined as p<0.05.
Results
Our analysis included 117 patients with resected pNETs, of whom 26 (22%) identified as Black and 91 (78%) identified as White. Gender distribution within our sample reflected 49.2% female and 50.8% male with no significant difference of ADI between males and females (p=0.54). Black pNET patients demonstrated significantly higher average ADI as compared to Whites (82.6 vs. 56.3, p=0.01) with overall average ADI in our sample population reflecting 63.7 ±24.4. Median ADI was 66. Average age for our sample population was 60.2 ±11 years, and age was positively associated with higher ADI (p=0.38). Average tumor size was 30.6 ±23.5cm with no association between tumor size and ADI (p=0.52). Most patients presented with stage II disease at 47.5%. There was no significant association between age, gender, tumor size, or stage with ADI. Within our sample population, no difference in DFS between low versus high ADI was observed (p=0.28). When adjusted for race, DFS was not shown to be significant between low versus high ADI by race (p=0.19).
Discussion
In our study, Black pNET patients are more likely to reside in resource deprived neighborhoods as compared to the White counterparts. However, no significant association was seen between resource deprivation and DFS. Validation in a larger sample population is warranted.
Back to 2023 Posters