Why do black Americans have a higher risk of pancreatic cancer than white Americans?

Debra T. Silverman, Robert N. Hoover, Linda M. Brown, G. Marie Swanson, Marie Schiffman, Raymond S. Greenberg, Richard B. Hayes, Keith D. Lillemoe, Janet B. Schoenberg, Ann G. Schwartz, Jonathan Liff, Linda M. Pottern, Joseph F. Fraumeni

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background. For several decades, the incidence of pancreatic cancer has been 50% to 90% higher among blacks than among whites in the United States. The purpose of this study was to identify risk factors that may contribute to this racial disparity. Methods. We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. In-person interviews were exclusively with subjects (526 cases and 2153 population controls), rather than with next of kin. Results. The determinants of the higher incidence of pancreatic cancer among blacks than among whites differed by sex. Among men, established risk factors (ie, cigarette smoking, long-term diabetes mellitus, family history of pancreatic cancer) account for 46% of the disease in blacks and 37% in whites, potentially explaining all but 6% of the excess risk among blacks. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption (>7 drinks per week) and elevated body mass index (above the first quartile). When these less accepted risk factors were combined with the established risk factors, 88% of the disease in black women and 47% in white women were explained, potentially accounting for all of the excess risk among blacks in our female study population. Conclusions. Among men, the established risk factors (mainly cigarette smoking and diabetes mellitus) explain almost the entire black/white disparity in incidence. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption and elevated body mass index. In the absence of these factors, pancreatic cancer incidence rates among blacks probably would not exceed those among whites of either sex.

Original languageEnglish (US)
Pages (from-to)45-54
Number of pages10
JournalEpidemiology
Volume14
Issue number1
DOIs
StatePublished - Jan 2003
Externally publishedYes

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Pancreatic Neoplasms
Incidence
Alcohol Drinking
Diabetes Mellitus
Body Mass Index
Smoking
Population Control
Population
Case-Control Studies
Interviews
hydroquinone

Keywords

  • Alcohol consumption
  • Body mass index
  • Cigarette smoking
  • Diabetes mellitus
  • Pancreatic neoplasm
  • Race
  • Socioeconomic factors

ASJC Scopus subject areas

  • Epidemiology

Cite this

Silverman, D. T., Hoover, R. N., Brown, L. M., Swanson, G. M., Schiffman, M., Greenberg, R. S., ... Fraumeni, J. F. (2003). Why do black Americans have a higher risk of pancreatic cancer than white Americans? Epidemiology, 14(1), 45-54. https://doi.org/10.1097/00001648-200301000-00013

Why do black Americans have a higher risk of pancreatic cancer than white Americans? / Silverman, Debra T.; Hoover, Robert N.; Brown, Linda M.; Swanson, G. Marie; Schiffman, Marie; Greenberg, Raymond S.; Hayes, Richard B.; Lillemoe, Keith D.; Schoenberg, Janet B.; Schwartz, Ann G.; Liff, Jonathan; Pottern, Linda M.; Fraumeni, Joseph F.

In: Epidemiology, Vol. 14, No. 1, 01.2003, p. 45-54.

Research output: Contribution to journalArticle

Silverman, DT, Hoover, RN, Brown, LM, Swanson, GM, Schiffman, M, Greenberg, RS, Hayes, RB, Lillemoe, KD, Schoenberg, JB, Schwartz, AG, Liff, J, Pottern, LM & Fraumeni, JF 2003, 'Why do black Americans have a higher risk of pancreatic cancer than white Americans?', Epidemiology, vol. 14, no. 1, pp. 45-54. https://doi.org/10.1097/00001648-200301000-00013
Silverman DT, Hoover RN, Brown LM, Swanson GM, Schiffman M, Greenberg RS et al. Why do black Americans have a higher risk of pancreatic cancer than white Americans? Epidemiology. 2003 Jan;14(1):45-54. https://doi.org/10.1097/00001648-200301000-00013
Silverman, Debra T. ; Hoover, Robert N. ; Brown, Linda M. ; Swanson, G. Marie ; Schiffman, Marie ; Greenberg, Raymond S. ; Hayes, Richard B. ; Lillemoe, Keith D. ; Schoenberg, Janet B. ; Schwartz, Ann G. ; Liff, Jonathan ; Pottern, Linda M. ; Fraumeni, Joseph F. / Why do black Americans have a higher risk of pancreatic cancer than white Americans?. In: Epidemiology. 2003 ; Vol. 14, No. 1. pp. 45-54.
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title = "Why do black Americans have a higher risk of pancreatic cancer than white Americans?",
abstract = "Background. For several decades, the incidence of pancreatic cancer has been 50{\%} to 90{\%} higher among blacks than among whites in the United States. The purpose of this study was to identify risk factors that may contribute to this racial disparity. Methods. We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. In-person interviews were exclusively with subjects (526 cases and 2153 population controls), rather than with next of kin. Results. The determinants of the higher incidence of pancreatic cancer among blacks than among whites differed by sex. Among men, established risk factors (ie, cigarette smoking, long-term diabetes mellitus, family history of pancreatic cancer) account for 46{\%} of the disease in blacks and 37{\%} in whites, potentially explaining all but 6{\%} of the excess risk among blacks. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption (>7 drinks per week) and elevated body mass index (above the first quartile). When these less accepted risk factors were combined with the established risk factors, 88{\%} of the disease in black women and 47{\%} in white women were explained, potentially accounting for all of the excess risk among blacks in our female study population. Conclusions. Among men, the established risk factors (mainly cigarette smoking and diabetes mellitus) explain almost the entire black/white disparity in incidence. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption and elevated body mass index. In the absence of these factors, pancreatic cancer incidence rates among blacks probably would not exceed those among whites of either sex.",
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AU - Hoover, Robert N.

AU - Brown, Linda M.

AU - Swanson, G. Marie

AU - Schiffman, Marie

AU - Greenberg, Raymond S.

AU - Hayes, Richard B.

AU - Lillemoe, Keith D.

AU - Schoenberg, Janet B.

AU - Schwartz, Ann G.

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AU - Pottern, Linda M.

AU - Fraumeni, Joseph F.

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N2 - Background. For several decades, the incidence of pancreatic cancer has been 50% to 90% higher among blacks than among whites in the United States. The purpose of this study was to identify risk factors that may contribute to this racial disparity. Methods. We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. In-person interviews were exclusively with subjects (526 cases and 2153 population controls), rather than with next of kin. Results. The determinants of the higher incidence of pancreatic cancer among blacks than among whites differed by sex. Among men, established risk factors (ie, cigarette smoking, long-term diabetes mellitus, family history of pancreatic cancer) account for 46% of the disease in blacks and 37% in whites, potentially explaining all but 6% of the excess risk among blacks. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption (>7 drinks per week) and elevated body mass index (above the first quartile). When these less accepted risk factors were combined with the established risk factors, 88% of the disease in black women and 47% in white women were explained, potentially accounting for all of the excess risk among blacks in our female study population. Conclusions. Among men, the established risk factors (mainly cigarette smoking and diabetes mellitus) explain almost the entire black/white disparity in incidence. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption and elevated body mass index. In the absence of these factors, pancreatic cancer incidence rates among blacks probably would not exceed those among whites of either sex.

AB - Background. For several decades, the incidence of pancreatic cancer has been 50% to 90% higher among blacks than among whites in the United States. The purpose of this study was to identify risk factors that may contribute to this racial disparity. Methods. We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. In-person interviews were exclusively with subjects (526 cases and 2153 population controls), rather than with next of kin. Results. The determinants of the higher incidence of pancreatic cancer among blacks than among whites differed by sex. Among men, established risk factors (ie, cigarette smoking, long-term diabetes mellitus, family history of pancreatic cancer) account for 46% of the disease in blacks and 37% in whites, potentially explaining all but 6% of the excess risk among blacks. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption (>7 drinks per week) and elevated body mass index (above the first quartile). When these less accepted risk factors were combined with the established risk factors, 88% of the disease in black women and 47% in white women were explained, potentially accounting for all of the excess risk among blacks in our female study population. Conclusions. Among men, the established risk factors (mainly cigarette smoking and diabetes mellitus) explain almost the entire black/white disparity in incidence. Among women, however, other factors appear to contribute to the racial disparity, notably moderate/heavy alcohol consumption and elevated body mass index. In the absence of these factors, pancreatic cancer incidence rates among blacks probably would not exceed those among whites of either sex.

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KW - Body mass index

KW - Cigarette smoking

KW - Diabetes mellitus

KW - Pancreatic neoplasm

KW - Race

KW - Socioeconomic factors

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