S247 Trends in Pancreatic Cancer Mortality With Comorbid Hypertension in the United States, 1999 to 2023: A Retrospective Analysis

Introduction: Pancreatic cancer is a highly aggressive malignancy with poor prognosis and increasing incidence worldwide. Hypertension (HTN), a common chronic condition, may affect pancreatic cancer outcomes and mortality. This study examines mortality trends and disparities in pancreatic cancer among adults (≥45) with HTN in the United States from 1999 to 2023. Methods: This retrospective study utilized CDC WONDER data to analyze pancreatic cancer (C25) mortality with coexisting HTN (I10–I15) in the United States from 1999 to 2023. Crude and age-adjusted mortality rates (AAMRs) per 100,000 were extracted. Joinpoint regression was employed to calculate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals. Results: Pancreatic cancer with comorbid HTN resulted in 71,301 deaths over 25 years. The overall AAMR rose from 0.98 to 3.78, with an AAPC of 5.33 (95% CI: 4.88 to 5.79). AAMRs increased sharply from 1999 to 2001 (APC: 17.25, 95% CI: 7.99 to 24.16), followed by a moderate rise till 2007 (APC: 5.13, 95% CI: 2.00 to 7.28). Slower growth was seen from 2007 to 2018 (APC: 1.89, 95% CI: 0.16 to 2.48), then a spike from 2018 to 2021 (APC: 13.03, 95% CI: 10.07 to 15.12), and a plateau from 2021 to 2023 (APC: 2.73, 95% CI: -0.29 to 6.03). Men consistently exhibited higher mortality rates than women and the trajectory of increase was steeper in men (6.02, 95% CI: 5.61 to 6.64) compared to women (4.42, 95% CI: 4.01 to 5.04) All racial groups showed rising mortality, with the greatest rise seen in Non-Hispanic Whites (AAPC: 6.10, 95% CI: 5.48 to 7.11). Regionally, the South experienced the steepest rise (AAPC: 6.86, 95% CI: 6.17 to 7.47). Non-metropolitan areas exhibited higher AAMRs than metropolitan areas plus the increase in mortality was also steeper in non-metropolitan areas (5.10, 95% CI: 4.58 to 6.05). Age-stratified analysis showed the 45–54 age group with the sharpest increase (AAPC: 7.81, 95% CI: 7.07 to 8.91). Most deaths occurred in decedent’s home (48.25%). Conclusion: Pancreatic cancer with comorbid HTN mortality has significantly increased over the past 25 years, with higher mortality rates observed in men, Non-Hispanic Whites, and residents of the South. Mortality rates were also consistently higher in non-metropolitan areas compared to metropolitan ones. These findings highlight the growing burden of pancreatic cancer with HTN and the need for targeted public health interventions to address this trend.