Abstract C049: Neighborhood-level socioeconomic status influences supportive care medication use among older adults with pancreatic cancer

Abstract Background: Pancreatic cancer (PC) is associated with increased symptom burden as compared to other types of cancer, with supportive care medications (SCMs) serving as a cornerstone of management. Previous research has demonstrated that there are differences in SCM use based on race and ethnicity, likely with multiple explanatory factors. This study sought to investigate how neighborhood-level socioeconomic status influences the use of SCM amongst patients with PC. Methods: We used SEER-Medicare data from 2005-2020 to identify adults aged 65+ diagnosed with PC, and had continuous Medicare A/B coverage at least 90 days prior to PC diagnosis, and Medicare Part D coverage for at least 30 days. SCM use was defined as at least one prescription claim post-PC diagnosis for any of five categories: analgesics, psychotropics, anti-nausea, appetite stimulants, or sleep aids. Neighborhood SES was assessed using the Yost Index and aggregated into quintiles. Multivariable logistic regression models estimated the association between SES quintile and odds of SCM use, adjusting for race/ethnicity, rurality, age, marital status, comorbidity index, and cancer stage/location. Results are presented as covariate-adjusted odds ratios (aOR) with 95% confidence intervals (CIs). A two-sided p-value 0.05 was considered statistically significant. Patients in the highest Yost Index quintiles (Yost Q5) were the reference group for all comparisons. Results: After application of our predefined inclusion criteria, 83,987 patients were included in the final analysis. A clear SES gradient was observed, with patients with lower neighborhood-level SES having less odds of SCM use as compared to patients in higher neighborhood SES status (Yost Q1: 0.76 0.70-0.83; Q2: 0.77 0.72-0.83; Q3: 0.86 0.81-0.91; Q4: 0.93 0.87-0.97). The observed SES gradient was persistent across multiple drug classes but most pronounced for sleep aids, antiemetics, and psychotropics. Conclusion: SCM use in patients with PC is patterned by neighborhood SES, with lower use among socioeconomically disadvantaged groups. Given the general low cost of SCM and universal Medicare coverage among the study population, these disparities likely reflect deeper structural or behavioral factors—including differential symptom recognition, patient-clinician communication, prescribing patterns, or varied coping mechanisms. Further research is needed to explore how SES shapes SCM use, provider prescribing practices, and patient/family perceptions of SCM use, which will ultimately allow for the development of targeted interventions to ensure equitable symptom management. Citation Format: Kourtney A. Byrd, Olga M. Trejos Kweyete, Yi Guo, Shuang Yang, Xiwei Lou, Sherise C. Rogers, Lisa Scarton, Diana J. Wilkie, John M. Allen. Neighborhood-level socioeconomic status influences supportive care medication use among older adults with pancreatic cancer abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C049.