Social Determinants of Health as Epigenetic Drivers of Disparities in Pancreatic Neuroendocrine Tumors

There are known health outcome disparities among those with pancreatic neuroendocrine tumors (pNET) of minority race and those living with adverse social determinants of health (SDOH) (rurality, unmarried) influencing overall survival compared to their peers. The potential biologic mechanism of these factors is unknown. Our lab explores differential epigenetic expression of pnet tumors based on environmental exposures including race/ancestry and exposure to adverse social determinants of health. Our preliminary data show significant biologic changes are seen in pNET gene expression of patients living in neighborhoods characterized by adverse SDOH. The pathways most effected center around suppressed immune response and heightened catabolism. These changes may be linked to disparate outcomes among minorities.