S231 Disproportionate Escalation in Pancreatic Cancer Burden Attributable to High BMI in 38 OECD Countries: Trends by Age, Gender, and Country, 1990 to 2021

Introduction: Pancreatic cancer (PC) represents a growing public health challenge globally, with obesity increasingly identified as a key modifiable risk factor. Understanding temporal trends in PC burden attributable to high body mass index (BMI) in economically developed regions, particularly within the OECD nations, is essential for targeted preventive strategies and resource allocation. Methods: Using the GBD 2021 comparative risk framework, we calculated the PC burden attributable to high BMI through population attributable fraction-based estimation methods. Outcomes assessed included age-standardized mortality (ASMR), DALYs, and YLDs across 38 OECD nations, with stratification by sex, age, year and location. Long-term trends were expressed using annual percentage change (APC). Results: The burden of PC attributable to high BMI in OECD countries increased substantially from 1990 to 2021: deaths counts rose from 1,157.6 (95% UI: –942.1 to 4,642.0) to 5,831 (–739 to 15,579) with an APC of 5.35%; DALYs increased from 28,721 (–20,441 to 110,204) to 132,409 (–9,795 to 339,833) with an APC of 5.05%; and YLDs rose from 242 (–185 to 962) to 1,231 (–121 to 3,332), reflecting an APC of 5.38%. Nationally, the highest APC increase in ASMR was observed in Portugal 9.23%, followed by France 8.85%, Colombia 6.21%, Italy 5.25%, and the United States 2.66%. The highest APC in DALYs rate (ASDALR) was in France 8.66%, followed by Portugal 7.27%, Colombia 5.59%, and the U.S. 2.38%. Age-specific analysis showed deaths rose from 122.5 to 472.4 among those aged 20–54 years (APC: 4.45%), and from 1,035.0 to 5,358.7 in individuals aged 55 years and older (APC: 5.45%). DALYs increased from 5,055.3 to 19,739.4 for the 20–54 age group (APC: 4.49%) and from 23,665.9 to 112,670.2 for the 55+ group (APC: 5.16%). Gender-wise, the overall PC burden attributable to high BMI was higher among men across all measures, with APCs for ASMR (men: 4.94%, women: 2.46%), ASDALR (men: 4.33%, women: 2.40%), and ASYLDsR (men: 4.85%, women: 2.64%). Conclusion: In 2021, OECD countries accounted for 63.27% of all deaths due to PC attributable to high BMI, globally. The rising burden in OECD countries reflects increasing obesity rates, aging populations, and inadequate early prevention. With notable surges among men and younger adults, urgent action is needed through targeted obesity prevention, metabolic health screening, and risk-based cancer surveillance.