LAUSR

e18148 Background: Recent studies have demonstrated racial disparities in pancreatic ductal adenocarcinoma (PDAC) treatment. Black patients with PDAC are less likely to undergo surgery or receive systemic therapy compared to white patients. One explanation for this may be access to healthcare. The aim of this study is to evaluate racial disparities in treatment of PDAC patients in a cohort of United States Veterans with equal insurance access. Methods: This study is a multicenter, retrospective cohort study. The VA Central Cancer Registry was used to identify patients diagnosed with PDAC from Oct 1st, 1998-Dec 31st, 2014. This cohort was divided into surgically resected and advanced/unresectable groups. The primary outcome for the surgery cohort is the association between race and receipt of adjuvant therapy. The metastatic cohort includes patients with stage III/IV without surgery record. The primary outcome is the association between race and recorded chemotherapy within 6 months of diagnosis. Primary outcomes were assessed using multivariable logistic regression controlling for age and comorbidities. Associations between race and survival for each sub-cohort were assessed using cox proportional hazards analysis. Results: The surgery cohort consisted of 1,835 patients of whom 356 (19%) were black and 1,433 (78%) were white, with 660 (36%) receiving adjuvant treatment. There was no association between race and receipt of adjuvant treatment (OR 1.00, 95% CI 0.78-1.28). There was no difference in survival up to 3 years in white patients compared to black patients (HR 0.99, 95% CI 0.86-1.14). The metastatic disease cohort consisted of 7,983 patients of whom 1,610 (20%) were black and 6150 (78%) were white, with 2,885 (36%) receiving chemotherapy. There was no association between race and receipt of chemotherapy in patients with advanced disease (OR 1.02, 95% CI 0.91-1.15). There was no difference in survival up to 1 year in white patients compared to black patients (HR 0.96, 95% CI 0.90-1.01). Conclusions: This study failed to demonstrate an association between race and adjuvant therapy or systemic therapy administration. There was no difference in overall survival in this cohort. Previously described racial disparities in the treatment of advanced PDAC do not extend to the equal insurance access VA Health Care System.