Regional trends in disability adjusted life years (DALYs) and mortality of pancreatic cancer among older adults (70+): A global burden of disease study (1990–2021).

11153 Background: Pancreatic cancer is a major health challenge, particularly for older adults, with significant regional disparities in its burden over the decades. This study analyzes 30-year trends in pancreatic cancer DALYs and deaths among older adults across regions. Methods: We used Global Burden of Disease (GBD) data (1990–2021) to analyze age-standardized DALYs and deaths for individuals aged 70+. Trends were assessed using AAPCs and APCs, stratified by region and socio-demographic index (SDI). Results: Regions with lower SDI (e.g., Sub-Saharan Africa, South Asia) showed higher AAPCs, indicating greater increases in DALYs and deaths compared to high-income regions (e.g., North America, Western Europe). Low-middle SDI regions, Central Asia, and Southeast Asia saw significant increases in deaths, while Southern Latin America and the Caribbean experienced slight declines. In Eastern Europe, pancreatic cancer DALYs and deaths increased at an AAPC of 1.45% and 1.50%, respectively, showing a moderate but concerning rise in burden. Meanwhile, Central Sub-Saharan Africa experienced a sharp increase, with DALYs and deaths rising at an AAPC of 2.10% and 2.15%. In contrast, Oceania saw only a slight increase, with DALYs and deaths rising at an AAPC of 0.50% and 0.55% showing a relatively stable burden compared to other regions. The highest death rates are observed in High-income Asia Pacific (109.30 in 2021) and Southern Latin America (85.01 in 2021), while the lowest death rates are in South Asia (12.17 in 2021) and Low SDI regions (14.00 in 2021). For DALYs, the highest rate was 1462.27 per 100,000 population in High-income Asia Pacific in 2016, while the lowest rate was 131.06 per 100,000 population in South Asia in 1990. Conclusions: The burden of pancreatic cancer among older adults is increasing at a faster rate in regions with lower socio-demographic development, while more affluent areas are seeing relatively stable trends. These stark disparities highlight the urgent need for focused healthcare efforts, better distribution of resources, and stronger preventive measures in regions where the impact of pancreatic cancer is growing most rapidly. Tackling these inequalities will demand global collaboration and customized strategies to lessen the rising toll of pancreatic cancer on older populations around the world. Region DALYs AAPC (%) Deaths AAPC (%) Trend Western Sub-Saharan Africa 2.25 (2.22–2.28) 2.31 (2.28–2.35) Highest increase, growing burden North Africa & Middle East 1.67 (1.62–1.72) 1.77 (1.73–1.82) Steady rise Low-middle SDI Regions 1.59 (1.56–1.63) 1.65 (1.62–1.70) Substantial increases High-income North America 0.22 (0.18–0.26) 0.29 (0.25–0.32) Lowest increases Southern Latin America -0.18 (-0.27–-0.10) -0.03 (-0.08–0.02) Decrease in burden Caribbean -0.12 (-0.21–-0.02) -0.03 (-0.14–0.06) Decrease in burden