Aggarwal, Manik

ABSTRACT Endoscopic retrograde cholangiopancreatography–guided transpapillary gallbladder drainage has emerged as an effective alternative for management of acute cholecystitis in nonoperable candidates. Delayed acute pancreatitis has not been previously described as an adverse event with this procedure. In this article, we describe 3 patients who developed acute pancreatitis between 2 and 6 weeks after stent insertion with no alternative inciting cause. Delayed acute pancreatitis may represent a rare and previously uncharacterized adverse event related to transpapillary gallbladder drainage.

Abstract Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the United States (US). Primary care physicians (PCP) are critical towards a successful CRC screening program. However, the impact of availability of PCP on CRC-related mortality is not well studied. Materials and Methods: We extracted data on crude incidence and mortality rates of CRC among all 50 states and District of Columbia (D.C.) from the Center for Disease Control (CDC) WONDER database for the year 2019. Data on number of actively practicing PCPs in all 50 states and D.C. for the year 2020 were obtained from Association of American Medical Colleges (AAMC) State Physician Workforce Data Report. The correlation between the ratio of number of PCPs per CRC case with age-adjusted mortality rate (AAMR) for CRC was studied by state and within White and African American (AA) populations from 2017-2019. Pearson’s co-efficient was used to study correlations and T-test was used for comparing independent samples. Statistical analysis was performed using VassarStats. Results: The median AAMR for CRC from 2017-2019 in the US was 13.2 (IQR 11,15.4) per 100,000 population. AAMR for CRC was significantly higher among AA versus White populations (t=5.79, p<0.001). The national median PCP per CRC case ratio was 2.14 (IQR 1.46, 2.82). Higher state-wide PCP per CRC case ratio correlated with lower state CRC-related mortality (r=-0.36, p=0.011). PCP per CRC case ratio was significantly lower among AA as compared to White populations (t=-15.95, p<0.0001). Higher PCP per CRC case ratio correlated with lower CRC-related mortality among both White (r=-0.64, p<0.0001) and AA (r=-0.57, p=0.0002) populations. Using Fisher r-to-z transformation, we found no significant difference between the correlation of PCP per CRC case ratio with CRC-related mortality in White versus AA populations (z=-0.51, p=0.61). Conclusion: Results of this study suggest that greater availability of primary care physicians correlates with lower CRC-related mortality. AA have a significantly higher AAMR for CRC with a lower PCP per CRC case ratio. This may indicate a lower access to primary care among AA populations with CRC. Our results underscore the need to expand access to primary care among AA populations with the goal of minimizing disparities in CRC-related mortality. Citation Format: Udhayvir S. Grewal, Shiva J. Gaddam, Manik Aggarwal, Subhash C. Garikipati, Prabhat Kumar, Naomi Fei. Correlation of availability of primary care physicians and colorectal cancer-related mortality in the United States: Do racial disparities exist. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6488.