Trends in pancreatic cancer mortality among US adults, 1999-2023

Pancreatic cancer (PC) is characterized by an extremely poor prognosis and a high mortality rate, posing a significant burden on society.

We analyzed PC mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2023. Annual death counts and age-adjusted mortality rates (AAMRs) were calculated and stratified by sex, age, race/ethnicity, state, census region, and 2013 urbanization level. Temporal trends were evaluated using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs) with 95% confidence intervals. Analyses by urbanization level were limited to 1999-2020 due to data availability.

In 2023, there were 49,441 deaths from PC in the United States, representing a 70.03% increase compared to 1999. During the same period, the AAMR for PC rose from 16.41 (95%CI: 16.22-16.60) to 17.33 (95%CI: 17.17-17.48) per 100,000 population, showing a statistically significant upward trend. This increase was observed in both males and females, with a more pronounced increase among males, with an AAPC of 0.24 (95%CI: 0.19-0.30). Age subgroup analysis revealed that individuals aged 55 and older had higher mortality rates, which continued to rise, while mortality rates declined among those under 55. Although the AAMR for non-Hispanic(NH) Black individuals declined from 1999 to 2023, with an AAPC of -0.19 (95% CI: -0.26 to -0.12), it remained the highest among all racial and ethnic groups, with an AAMR of 20.68 (95% CI: 20.14-21.22). Geographically, the Midwest exhibited a higher AAMR (18.72, 95% CI: 18.36-19.07) and a more pronounced growth trend (AAPC = 0.52, 95% CI: 0.46-0.59). In addition, non-metropolitan areas have higher AAPC (0.62, 95CI: 0.53-0.72). And in 2020, AAMR value is higher than that of metropolitan area.

PC remains a significant and rising burden in the United States, with notable disparities by sex, age, race/ethnicity, and region. These findings highlight the importance of targeted prevention strategies, such as smoking cessation and metabolic risk control, and improving access to specialized care in non-metropolitan areas. Strengthening early detection efforts and optimizing resource allocation may help reduce these disparities and improve outcomes.