Abstract A012: Pancreatic cancer mortality among the homeless in the United States: A CDC WONDER-based proxy analysis of place of death and demographic patterns, 1999–2020

Abstract Background: Pancreatic cancer remains one of the deadliest malignancies in the United States. Individuals experiencing homelessness face major barriers to timely diagnosis, treatment, and palliative care. Given the absence of housing status identifiers in national mortality data, this study used “Other” place of death—including streets, public spaces, shelters, or unknown locations as a proxy to examine trends and demographics linked to homelessness in pancreatic cancer deaths from 1999 to 2020. Methods: Mortality data were obtained from the CDC WONDER Multiple Cause of Death database (1999–2020) for cases listing pancreatic cancer (ICD-10 C25.0–C25.9) as the underlying cause. Deaths categorized under “Other” place of death were considered proxies for presumed homelessness. Descriptive analyses were conducted by race, sex, age, U.S. census region, and weekday of death. National mortality estimates were used to calculate the proportion of presumed homelessness-associated deaths. Results: From 1999 to 2020, 46,333 pancreatic cancer deaths were recorded in the “Other” category, representing 5.7% of an estimated 810,628 total pancreatic cancer deaths nationally. Annual deaths in this category rose from 1,781 in 1999 to 2,208 in 2020—a 24% increase suggesting a growing burden among individuals outside formal care settings. Most presumed homelessness-associated deaths occurred among White individuals (n = 39,563), followed by Black or African American (n = 4,876) and Asian or Pacific Islander (n = 457). A total of 2,329 deaths were identified as Hispanic or Latino. Females accounted for 55% (n = 25,570) of deaths, and males 45% (n = 19,326). Most deaths were among adults aged 75–84 years (n = 14,063), 65–74 years (n = 11,223), and ≥85 years (n = 8,714), but a notable number occurred among those aged 45–64 (n = 10,508), highlighting a burden of premature mortality. Regionally, the South had the highest number of presumed homelessness-associated deaths (n = 14,355), followed by the West (n = 5,937), Midwest (n = 5,890), and Northeast (n = 2,893). Deaths were fairly evenly distributed across weekdays, with slightly higher numbers on Fridays (n = 4,343), Sundays (n = 4,338), and Saturdays (n = 4,293). Conclusions: Pancreatic cancer mortality among individuals presumed to be experiencing homelessness has steadily increased over two decades, comprising a significant proportion of national deaths. Demographic patterns including racial disparities, female predominance, older age at death, and regional clustering in the South highlight the urgent need for equity-driven public health strategies and improved housing-related data collection to better support vulnerable populations affected by cancer. Citation Format: Abdu Mohammed, Adamseged I. Gebremedhen, Ahmed Ali. Pancreatic cancer mortality among the homeless in the United States: A CDC WONDER-based proxy analysis of place of death and demographic patterns, 1999–2020 [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A012.