Innovative Trials are passionate about ensuring our diverse population is adequately represented within medical research. Whether it is wanting to see more people from underrepresented communities choosing science as a career and pushing for greater patient diversity in clinical trials or focusing on what we are doing internally to celebrate and promote equality and diversity. This month we celebrate Pancreatic Cancer Awareness Month. So far the Equality, Diversity, and Inclusion Committee at Innovative Trials has written blogs to raise awareness surrounding several illnesses, their effects, and treatments such as World Lupus Day, Malaria, Pride Month, Sickle Cell. and Endometriosis , and
What is it and What are the Facts?
Pancreatic cancer occurs when cells in the pancreas start to grow uncontrollably, forming a tumor and leading to a range of symptoms. One of the challenges with pancreatic cancer is that it often goes undetected until it reaches advanced stages, making it very difficult to treat. According to Cancer Research UK, 1 in 53 males and 1 in 57 females in the UK will be diagnosed with pancreatic cancer in their lifetime. It is predicted that only 5% of people diagnosed with pancreatic cancer in England survive their disease for ten years or more. A person’s risk of developing cancer depends on many factors, including age, genetics, and exposure to risk factors such as smoking and obesity.
Symptoms and Risk Factors
Pancreatic cancer often does not cause symptoms in its early stages, and when symptoms do appear, they can be vague and easily attributed to other conditions. Some common symptoms may include:
Jaundice: Yellowing of the skin and eyes due to the accumulation of bilirubin. This can occur if the tumor blocks the bile duct.
Abdominal pain: Pain or discomfort in the upper abdomen or back, which may be more noticeable after eating.
Weight loss: Unexplained weight loss, even if the person is eating normally.
Digestive problems: Changes in bowel habits, such as pale-colored stools, dark urine, and greasy or floating stools, may occur.
New-onset diabetes: Diabetes that develops suddenly and without a clear cause may be associated with pancreatic cancer.
Fatigue: Feeling tired and weak, which can be a result of the cancer and the body’s response to it.
Risk factors may increase one’s likelihood of developing certain diseases or conditions. Some pancreatic cancer risk factors include:
Age: The risk of pancreatic cancer increases with age, and it is more common in individuals over the age of 60.
Smoking: Cigarette smoking is a significant risk factor for pancreatic cancer.
Family history: Individuals with a family history of pancreatic cancer or certain genetic syndromes may have an increased risk.
Chronic pancreatitis: Long-term inflammation of the pancreas may increase the risk of developing pancreatic cancer.
Diabetes: Chronic diabetes, especially type 2 diabetes, is associated with an increased risk of pancreatic cancer.
Obesity: Being overweight or obese may contribute to an elevated risk.
It is essential to talk to a healthcare professional about individual risk factors and undergo regular check-ups, especially if there is a family history of pancreatic cancer or other related conditions. Early detection can significantly improve the chances of successful treatment.
Pancreatic Cancer and Racial Background
Pancreatic cancer incidence rates are lower amongst Asian people and in people of mixed or multiple racial backgrounds, but higher among Black populations, compared with White, in England. It is also suggested that incidence rates of all cancers combined were significantly lower for non-White people compared with the White, except for Black males, where rates were higher compared with White males.
It has been suggested that certain types of cancer related to infections (e.g. liver, stomach, and cervical cancers), typically have a higher incidence among non-White people. Meanwhile, cancer types related to aspects of a ‘Western Lifestyle’ like smoking, excess body weight, and diet (e.g. bowel, lung, and pancreatic cancers), have a lower incidence among non-White people.
In England, cancer incidence increases in areas where socioeconomic deprivation is greater. Deprivation and non-White populations are also highly correlated in England, but this does not align with the above discussion highlighting lower pancreatic and overall cancer incidence rates in non-White groups. This possibly can be further explained by the ‘Healthy Migrant Effect’. This term refers to the observed phenomenon, where migrants often have better health outcomes than both the population in their home country and the population in their host country. In this context, individuals migrating from non-White populations may bring with them healthier behaviors and lifestyles, which could be contributing to a lower cancer incidence.
Patient Recruitment Recommendations
Cultural sensitivities: Be culturally sensitive in the recruitment process to account for potential cultural differences in healthcare attitudes, beliefs, and practices. This may help to improve communication, adherence to protocols, and overall patient experience.
Cultural factors in symptom recognition: Acknowledge that cultural differences may impact how symptoms are recognized and reported. Educational materials need to be tailored to address these cultural nuances.
Access to specialized care: Be mindful of disparities in access to specialized pancreatic cancer care among different ethnic groups. Develop strategies to ensure equitable access to clinical trials, address barriers that could impede participation.
Targeted outreach campaigns: Develop targeted outreach campaigns specifically focussed on communities with a higher prevalence of pancreatic cancer of relevant risk factors. Tailor messages to address the unique concerns and information needs of these communities.
Innovative Trials’ experiences in studies involving pancreatic cancer have shown that increasing awareness of the condition and the importance of early detection are key to improving outcomes for patients.
Understanding the nuances of pancreatic cancer is crucial in the journey toward more equitable healthcare outcomes. This aggressive disease often evades detection until advanced stages, posing significant challenges to effective treatment. As such, more research is needed to improve outcomes for pancreatic cancer patients and ensure that treatments are inclusive. Raising awareness is a helpful first step in achieving this. Work is ongoing and there are a number of studies taking place to solve the early detection challenge. A graphene sensor platform has recently been developed that initial research shows is able to detect pancreatic cancer biomarkers from blood plasma samples. Pancreatic Awareness Month 2023
Delon, C., Brown, K.F., Payne, N.W.S. et al., 2022. Differences in cancer incidence by broad ethnic group in England, 2013–2017. British Journal of Cancer 126, 1765–1773.
Arnold, M., Razum, O. & Coebergh, J., 2012. Cancer risk diversity in non-western migrants to Europe: an overview of the literature. European Journal of Cancer, 46(14), pp. 2647-2659.
Cancer Research UK, 2018. Cancer Research UK. [Online] Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/pancreatic-cancer#heading-Zero Accessed 13 November 2023.
National Cancer Institute, 2023. National Cancer Institute. [Online] Available at: https://www.cancer.gov/types/pancreatic Accessed 14 November 2023.
Imperial College London, 2023. Engineering – News. https://www.imperial.ac.uk/news/249173/graphene-sensor-could-enable-early-fast/