S24 Shifting Demographics: Investigating Pancreatic Cancer in Younger Populations

Introduction: Early-onset pancreatic cancer is on the rise, especially among younger women, notably Black and Hispanic individuals. Current screening targets high-risk patients with genetic or familial predispositions, with American Gastroenterological Association and American Society for Gastrointestinal Endoscopy recommending individualized approaches at specialized centers. The U.S. Preventive Services Task Force advises against routine screening in average-risk populations due to low yield and potential harms. Methods: This retrospective study evaluated all patients at a tertiary care center who underwent biopsy of a pancreatic mass between 09/2015 to 09/2024. Inclusion criteria included patients aged 18 to 39 at the time of pancreatic cancer diagnosis, with pathology confirming malignancy. Patients were excluded if imaging or biopsy was performed as part of screening due to a known genetic predisposition. Data were collected on demographics, medical, family, and social histories, as well as residential addresses and proximity to facilities listed by the United States Environmental Protection Agency as part of the Toxics Release Inventory. Results: Of 451 patients, 15 met inclusion criteria. The median age was 28 (IQR: 26.5–35.5), with 53.5% women and 60% identifying as Hispanic or Black. Pathology showed adenocarcinoma in 40% and neuroendocrine tumors (NET) in 33.3%. Median BMI was 26 (IQR: 23.4–34.4); 53.3% had a smoking history, and 73.3% consumed alcohol. Sixty percent lived near Environmental Protection Agency-designated chemical release sites, with an all-cause mortality rate of 13.3%. Among the 9 patients in higher-exposure areas, 33.3% had adenocarcinoma, 33.3% NET, 11.1% undifferentiated carcinoma, and 22.2% solid pseudopapillary neoplasms. This subgroup was 66.7% Hispanic or Black, 55.6% women, and had a 22.2% mortality rate. Conclusion: The results highlight a rising incidence of pancreatic cancer in young adults, particularly among Hispanic, Black, and female patients. Most lived near areas of significant chemical exposure, which was linked to more aggressive cancer types and higher mortality. These findings suggest environmental carcinogens may be a relevant screening risk factor, warranting further study in larger populations.