A Yale-led study examined whether neighborhood socioeconomic conditions are linked to pancreatic cancer risk.
Researchers found a slightly higher risk among veterans living in the most advantaged neighborhoods, not the most disadvantaged ones.
The increase was small, and researchers say established risk factors such as smoking and alcohol use remain much more important.
Researchers have long known that where a person lives can affect many aspects of health. For several common cancers, neighborhood characteristics — including income, education, housing quality, and access to resources — have been linked to differences in disease risk. But whether those same factors play a role in pancreatic cancer has remained largely unknown.
A new Yale-led study set out to answer that question by examining the relationship between neighborhood socioeconomic conditions and pancreatic cancer.
The research focused on pancreatic ductal adenocarcinoma, the most common form of pancreatic cancer, which is often difficult to detect early because symptoms typically do not appear until the disease has advanced. While treatments have improved in recent years, researchers continue to investigate what contributes to the disease and whether certain groups may face higher risks.
“For some common cancers, a person’s neighborhood is correlated with their likelihood of developing the disease,” researcher Louise Wang, MD, said in a news release.
“We wanted to understand if this holds true for pancreatic cancer. Are individual-level risk factors, like genetics and lifestyle, the most significant, or do neighborhood-level factors play a role in the development of this cancer?”
How researchers studied the question
The study analyzed health records from more than 5 million veterans who received care through the Veterans Health Administration between 2001 and 2021. Researchers identified more than 31,000 people who were diagnosed with pancreatic ductal adenocarcinoma and compared their risk based on where they lived.
To measure neighborhood conditions, the team used the Area Deprivation Index, a tool that evaluates factors such as income, education, employment, and housing quality. Neighborhoods were grouped into 10 categories ranging from the most advantaged to the most disadvantaged.
The researchers also adjusted their analysis to account for a variety of factors that can influence pancreatic cancer risk, including age, race, body mass index, smoking, alcohol use, diabetes, pancreatitis, liver disease, pancreatic cysts, and other health conditions.
Because the Veterans Health Administration provides relatively equal access to healthcare, the researchers said it offered a useful setting for studying whether neighborhood characteristics themselves were associated with cancer risk.
What the findings mean for consumers
The researchers found an unexpected result: veterans living in the most socioeconomically advantaged neighborhoods had a slightly higher likelihood of being diagnosed with pancreatic cancer compared with those living in neighborhoods with average levels of deprivation.
“We were not expecting to see that individuals living in neighborhoods with higher incomes, education levels, and other forms of advantage would have increased risk of pancreatic cancer,” Dr. Wang said. “It’s possible that in those neighborhoods there is increased screening and surveillance, so people are diagnosed at a higher rate.”
No meaningful differences were found across the other neighborhood groups.
The authors caution that the increased risk was modest and should be interpreted carefully. They suggest one possible explanation is that people in more advantaged neighborhoods may receive more medical testing or monitoring, leading to more diagnoses. Other factors not captured in the study may also contribute.
Most importantly, the researchers emphasized that neighborhood characteristics appeared to play a much smaller role than well-established individual risk factors, such as smoking and alcohol use. They also noted that additional research is needed to determine whether the findings apply beyond the veteran population and in healthcare settings with different levels of access. 3