Epidemiological trends and burden of pancreatic cancer in the United States: A retrospective analysis from 1990 to 2023 with advanced machine learning forecasting to 2050.

e16402 Background: Pancreatic cancer remains a leading cause of cancer-related burden in the United States, with persistently high mortality and limited survival gains despite advances in diagnostics and treatment. This study analyzed age-standardized rates (ASRs) of DALYs, deaths, incidence, and prevalence from 1990 to 2023 using IHME GBD 2023 data, assessed trends via estimated annual percentage change (EAPC), and projected future burden to 2050 with ARIMA forecasting. Methods: Age-standardized rates per 100,000 population were extracted from the Global Burden of Disease 2023 database for the United States, stratified by sex (Both, Female, Male). Historical trends (1990–2023) were evaluated using EAPC derived from linear regression on log-transformed ASRs. Future projections (2024–2050) employed ARIMA models fitted to historical time series, generating point forecasts and 95% prediction intervals (PI). Results: From 1990 to 2023, age-standardized DALYs (Both sexes) fluctuated between 201.4 (1997) and 214.4 (2015–2016), with an overall EAPC of 0.16% (95% CI: 0.13–0.20). Females showed a higher increase (EAPC 0.20%, 95% CI: 0.17–0.23) than males (EAPC 0.09%, 95% CI: 0.05–0.13). Age-standardized death rates rose modestly (Both: EAPC 0.27%, 95% CI: 0.24–0.31; from ~8.95 in 1990 to ~9.56 in 2023), with similar sex patterns (Female EAPC 0.28%, Male 0.22%). Incidence exhibited the strongest historical growth (Both: EAPC 0.31%, 95% CI: 0.27–0.36; Female 0.34%, Male 0.25%), increasing from 9.65 (1990) to 10.53 (2023). Prevalence increased most rapidly (Both: EAPC 0.50%, 95% CI: 0.42–0.58), reflecting slightly better short-term survival. ARIMA forecasts indicate a gradual decline in age-standardized DALYs (Both: from 211.2 in 2024 to ~192.2 in 2050; 95% PI narrowing around downward trend), deaths (Both: from ~9.64 to ~10.16, but with widening intervals suggesting uncertainty), and incidence (Both: stabilizing then slight rise to ~11.24 by 2050), while prevalence continues upward to ~12.57 by 2050 due to aging population and modest survival gains. Conclusions: Pancreatic cancer burden in the US showed modest increases in age-standardized rates from 1990–2023, driven primarily by incidence and prevalence rises, with forecasts to 2050 predicting stabilization or slight declines in DALYs and mortality rates amid ongoing demographic pressures. These projections underscore the urgent need for improved prevention, early detection, and therapeutic innovations. Measure Sex EAPC Lower 95%CI Upper 95%CI DALYs Both 0.16 0.13 0.2 DALYs Female 0.2 0.17 0.23 DALYs Male 0.09 0.05 0.13 Deaths Both 0.27 0.24 0.31 Deaths Female 0.28 0.25 0.31 Deaths Male 0.22 0.18 0.26 Incidence Both 0.31 0.27 0.36 Incidence Female 0.34 0.31 0.38 Incidence Male 0.25 0.2 0.3 Prevalence Both 0.5 0.42 0.58 Prevalence Female 0.58 0.51 0.66 Prevalence Male 0.4 0.32 0.48