Incidence and disability burden of pancreatic cancer in the United States compared with high socio-demographic index countries: A global analysis, 1990–2023.

e16390 Background: Pancreatic cancer remains one of the most lethal malignancies worldwide, with limited improvements in long-term survival. Although incidence has increased globally, whether trends in mortality and disability burden differ between the United States (US) and other high Socio-demographic Index (SDI) countries is unclear. We compared long-term trends in incidence, mortality, and disability-adjusted life years (DALYs) attributable to pancreatic cancer in the US versus high SDI countries. Methods: We extracted pancreatic cancer–related incidence, mortality, and DALY data from the Global Burden of Disease (GBD) 2023 study. Age-standardized rates (ASRs) per 100,000 population were analyzed from 1990 to 2023 for the US and high SDI countries, stratified by sex. Temporal trends were evaluated using Joinpoint regression to estimate annual percentage changes (APCs) and average annual percentage changes (AAPCs) with 95% confidence intervals (CIs). Statistical significance was defined as P < 0.05. Results: In the US, age-standardized incidence increased from 9.65 per 100,000 in 1990 to 10.53 in 2023, with a significant AAPC of 0.30% (95% CI: 0.25–0.36; P < 0.001). Mortality increased from 8.95 to 9.56 per 100,000 (AAPC: 0.22%; 95% CI: 0.14–0.30; P < 0.001), while DALY rates rose from 203.7 to 211.2 per 100,000 (AAPC: 0.12%; 95% CI: 0.03–0.21; P = 0.009). Sex-stratified analyses demonstrated consistently greater increases among females in the US, including incidence (AAPC: 0.33%; P < 0.001), mortality (AAPC: 0.28%; P < 0.001), and DALYs (AAPC: 0.20%; P < 0.001), whereas trends among males were smaller and frequently nonsignificant.Across high SDI countries, incidence increased from 8.38 to 9.25 per 100,000 (AAPC: 0.30%; 95% CI: 0.19–0.41; P < 0.001), and mortality rose modestly (AAPC: 0.21%; 95% CI: 0.02–0.40; P = 0.028). In contrast, DALY rates remained largely stable over time (AAPC: 0.03%; P = 0.79), despite similar female-predominant incidence increases. Conclusions: From 1990 to 2023, pancreatic cancer incidence and mortality increased in both the US and high SDI countries; however, only the US experienced a sustained rise in disability burden, particularly among women, suggesting increasing survivorship with persistent functional impairment. These findings highlight disparities in disease impact and underscore the need for improved prevention, early detection, and treatment strategies.