Unmasking the lethality: National mortality patterns of pancreatic cancer in the U.S.

Abstract

680 Background: Pancreatic cancer continues to be a highly deadly disease, with survival rates improving more slowly than other common cancers. This study evaluates long-term U.S. mortality trends, examining variations across demographic groups and shifts in the place of death. Methods: We analyzed mortality data from the CDC WONDER database (1999–2023) for adults with pancreatic cancer (ICD-10: C25) as the underlying cause of death. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) were calculated per 100,000 population. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC). Subgroup analyses were performed by sex, race/ethnicity, age, region, urban–rural residence, and place of death. Results: From 1999 to 2023, 999,829 deaths were reported from pancreatic cancer in the U.S. The AAMR increased from 17.19 in 1999 to 18.53 in 2023 (AAPC: 0.35; p<0.000001). Men had a higher overall AAMR (20.37) (AAPC: 0.34) than women (15.40) (AAPC: 0.31). NH Blacks had the highest overall AAMR (22.47) while NH Asians had the lowest overall AAMR (12.34). Regionally, Northeast had the highest overall AAMR (18.32), followed by the Midwest (18.24), the South (17.48), and then the West (16.75). Majority of the deaths occurred at the decedent’s residence (483,382 deaths, 48.3%). Older adults showed the highest mortality (overall CMR: 66.42). Rural areas had higher overall AAMR (17.65) compared to urban areas (17.58). Conclusions: Deaths from pancreatic cancer are increasing in the U.S., with significant inequalities across different demographic and geographic groups. These results highlight the critical need for better early diagnosis, new treatments, and fair access to supportive care. Deaths and age-adjusted mortality rates (AAMRs) per 100,000 for trends related to pancreatic cancer mortality in adults in the United States between 1999 and 2023. Variable Deaths (n) AAMR (95% CI) Overall 999,829 17.65 (17.47 to 17.82) Sex  Female 491,221 15.40 (15.19 to 15.62)  Male 508,608 20.37 (20.08 to 20.66) Race/Ethinicity  NH American Indians 4,302 13.16 (11.04 to 15.33)  NH Asians 28,006 12.34 (11.56 to 13.12)  NH Blacks 119,596 22.47 (21.80 to 23.13)  NH White 784,446 17.80 (17.60 to 18.00)  Hispanics 63,276 13.86 (13.27 to 14.45)