M. Lin1, M. Gao1, Y. Yang1, J. Kim1 1University of Kentucky,Surgical Oncology,Lexington, KY, USA
Introduction: Pancreatic cancer is one of the most common cancers in the US and in the state of Kentucky (KY), it is the fourth most common GI cancer. The high incidence of pancreatic cancer may be attributed to high risk behavior such as cigarette smoking, which remains prevalent in KY. The objective of this study was to investigate the effect of smoking behavior to the high incidence of pancreatic cancer in KY.
Methods: The Kentucky Cancer Registry (KCR), a publicly available database, was audited for cancer data between 2011-2014. Pancreatic cancer incidence rate in KY was compared to the national incidence rate. Investigation of pancreatic cancer incidence in KY was divided by county. Next, since smoking is a known risk factor for pancreatic cancer, we investigated the effect of smoking on pancreatic cancer incidence rates. Using the KCR, we recorded incidence rates for lung cancer, which was used to quantitatively measure the distribution of smoking throughout the state.
Results: From 2011-2014, incidence rate for pancreatic cancer in the US was 12.5 per 100,000 people. In KY, 3,312 people were diagnosed with pancreatic cancer from 2011-2014, resulting in an incidence rate of 13.2 per 100,000 people. County data revealed an incidence rate of 11.4 for Fayette county, which contains the second largest city in KY. The counties immediately surrounding Fayette revealed incidence rates of 13.8 (Woodford), 16.0 (Jessamine), 14.1 (Clark). The largest city in KY, Louisville, is located in Jefferson county, which had a pancreatic cancer incidence rate of 14.1 per 100,000, while the surrounding counties were some of the highest: 16.7 (Oldham), 13.9 (Shelby), 12.8 (Bullitt).
To investigate causes of the high incidence of pancreatic cancer, we analyzed lung cancer incidence from 2011-2014, which yielded 94.7 per 100,000 for the state. Analysis of each county revealed highest incidence rate (179.9) for Owsley county, located in the southeast region of KY, where the incidence rate for lung cancer was the highest in the state. Comparatively, Fayette county had one of the lowest incidence rates for lung cancer, yielding 71.8 per 100,000. Similarly, the three surrounding counties also had relatively low incidence rates (69.2 to 98.8) compared to Owsley county. Jefferson had a lung cancer incidence rate of 89.2 per 100,000 and its three surrounding counties had lung cancer incidence rates ranging from 72.4 to 97.4.
Conclusion: While the pancreatic cancer incidence rate for KY was similar to that of the national incidence rate, data for each county revealed high incidence of pancreatic cancer in the counties immediately surrounding the two largest cities. Investigation of smoking behavior as a risk factor, measured by lung cancer incidence, revealed no significant correlation between smoking and pancreatic cancer incidence. Our future studies will investigate other possible risk factors contributing to the high incidence of pancreatic cancer in KY.