S47 Pancreatic Adenocarcinoma and Type 2 Diabetes Mellitus: Rising Mortality Trends in the United States

Introduction: Pancreatic cancer (PC) is the third leading cause of cancer deaths in the U.S. Type 2 diabetes (T2DM) is both a risk factor for and result of PC, linked to higher PC mortality. However, temporal and demographic patterns of PC and T2DM mortality in the U.S. are unclear. This study used national data to analyze mortality trends of PC and T2DM in the adult United States population from 2001 to 2020. Methods: Mortality data from the CDC WONDER database were analyzed for pancreatic adenocarcinoma and T2DM from 2001 to 2020 among adults aged 25 and above. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated. Annual percent change (APC) and average annual percent change (AAPC) were determined using Joinpoint regression, with trends stratified by year, sex, race/ethnicity, urbanization, and geographic region. Results: From 2001 to 2020, there were 20,095 deaths due to pancreatic adenocarcinoma and diabetes in individuals ≥25 in the United States with an overall AAMR 4.5. The AAMR increased from 2.7 in 2001 to 4.1 in 2008 (APC 4.91), increased to 4.0 in 2014 (APC 0.61), and then increased to 7.4 in 2020 (APC 10.42; AAPC 5.22). Men had a higher mortality rate than women throughout (AAMR men: 5.6; women: 3.7). Both had a consistent increase from 2001 to 2020 (AAPC men: 5.19; women: 4.84). Hispanics had a higher AAMR than non-Hispanic (NH) Black individuals and NH White (AAMR Hispanic 5.6; NH Black 5.4; NH White: 4.4). Hispanics had the highest increase from 2001 to 2020. (AAPC Hispanic 6.28; NH White: 4.92; NH Black 3.46;). Regionally, West had the highest mortality rate (AAMR West: 6.2) followed by Midwest (AAMR: 5.1), South (AAMR: 3.8) and Northeast (AAMR: 3.3). The West also had the highest AAPC (AAPC West 6.92; South 4.94; Northeast 3.28; Midwest: 3.27). Nebraska reported the highest state AAMR (8.8), and Nevada had the lowest (AAMR: 1.6). Rural areas had a higher AAMR than urban areas (AAMR Nonmetro 5.5; Metro 4.3). Conclusion: Mortality from PC and T2DM has consistently increased among United States adults. Elevated rates in Hispanic and NH Black populations highlight the need for targeted policies to improve treatment access and address modifiable risks. Higher rural mortality may reflect limited imaging and screening access. These findings emphasize the urgent need for equitable access to early diagnosis and treatment, particularly in underserved rural and minority populations disproportionately affected by rising pancreatic cancer mortality.