The Rising Burden of Premature Mortality Due to Pancreatic Cancer in the United States

Pancreatic cancer is characterized by its lethality and rapid progression, with many patients dying shortly after diagnosis. Mortality counts quantify the number of deaths, but fail to the capture the amount of expected lifespan lost. Years of life lost (YLL) measures premature mortality by estimating the years not lived when death occurs before an expected lifespan. In this study, we estimated national sex-, age-, and race/ethnicity-specific patterns and temporal trends in years of life lost to pancreatic cancer over a 25 year period (1999 to 2023).

Pancreatic cancer deaths (ICD-10 C25) were obtained from the National Vital Statistics System underlying cause of death mortality files (1999-2023). Years of life lost (YLL) were calculated by multiplying deaths at each single-year age and sex by remaining life expectancy from year- and sex-specific US life tables, and summing across ages. Temporal trends were summarized using annual percent change (APC) from log-linear regression of yearly totals. Race/ethnicity comparisons pooled 1999-2001 and 2021-2023 and estimated age-standardized YLL per 100,000 using the 2000 US standard population and life table.

From 1999 to 2023, 956,308 pancreatic cancer deaths accounted for 14,189,121 YLL. Annual YLL increased 76% from 416,228 to 733,772 (APC: 2.52%; 95% CI: 2.35-2.69; P < 0.0001), outpacing a 70% increase in deaths from 29,082 to 49,451 (APC: 2.26%; 95% CI: 1.38-3.15; P < 0.0001). Each death from pancreatic cancer resulted in a mean loss of 14.8 years of expected life. Adults aged 55-74 years accounted for 74% of the national increase in YLL. Cumulatively, from 1999 to 2023, males contributed 7.1 million YLL and females 6.8 million YLL. In 2021-2023, age-standardized YLL/100,000 was higher among Black individuals than White individuals (198.5 vs. 161.2). The absolute burden was geographically concentrated in California, Florida, Texas, and New York, who together accounted for an estimated 30.4% of the national YLL to pancreatic cancer.

Premature mortality from pancreatic cancer has increased substantially in the United States, with much of the increase concentrated among adults aged 55-74 years. Our findings support greater prioritization of pancreatic cancer research to define and mitigate the drivers causing this increase in loss of life.