What question did this study set out to answer?

This research aims to evaluate long-term trends in pulmonary embolism-related mortality among pancreatic cancer patients in the U.S. from 1999 to 2023.

May 30, 2026

Pulmonary embolism-related mortality in pancreatic cancer patients aged ≥45 years in the United States, 1999-2023: A CDC WONDER analysis.

Key Points

This research aims to evaluate long-term trends in pulmonary embolism-related mortality among pancreatic cancer patients in the U.S. from 1999 to 2023.
Analyzed U.S. mortality data from the CDC WONDER database for 1999–2023.
Identified deaths with pancreatic cancer and pulmonary embolism as causes of death.
Calculated age-adjusted mortality rates and estimated trends using joinpoint regression.
PE-related mortality increased significantly with an average annual percent change of 4.4% (95% CI 3.7-5.1; P < 0.001).
Marked increases among adults aged ≥65 years, with an annual rise of 9.8% after 2018 (95% CI 6.2–13.5).
Initial increases in mortality rates for both sexes after 2019 showed significant declines, contributing to non-significant overall trends.

Abstract

e16411 Background: Pancreatic cancer is among the most prothrombotic malignancies; however, long-term national trends in pulmonary embolism (PE)–related mortality within this population remain poorly defined. We evaluated temporal patterns and demographic disparities in PE-associated mortality among individuals with pancreatic cancer. Methods: We analyzed U.S. mortality data from the CDC WONDER database (1999–2023), identifying decedents with pancreatic cancer (ICD-10 C25) and PE (ICD-10 I26) listed as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC), stratified by age, sex, race, census region, and urbanization. Results: Overall PE-related mortality among individuals with pancreatic cancer increased significantly over the study period (AAPC 4.4%, 95% CI 3.7–5.1; P < 0.001). Rising trends were consistent across all census regions (AAPC range 4.0%–4.5%) and in both metropolitan (4.0%) and non-metropolitan (3.9%) areas. Age-stratified analyses demonstrated steady growth among adults aged 45–64 years (AAPC 4.3%), while those aged ≥65 years experienced a marked inflection in 2018, followed by rapid increases of 9.8% annually (95% CI 6.2–13.5). Significant long-term increases were observed among White (AAPC 4.5%) and Black or African American individuals (AAPC 4.6%). Sex-specific trends showed initial increases through 2019, followed by abrupt annual declines in males (−18.0%) and females (−18.5%), resulting in non-significant overall 24-year trends by sex. Most deaths occurred in medical facilities (60.1%, n = 6,135). Texas (n = 146) and Ohio (n = 105) reported the highest absolute numbers of deaths. Conclusions: PE-related mortality among individuals with pancreatic cancer has increased substantially over the past two decades, driven largely by a sharp rise in adults aged ≥65 years since 2018. The predominance of inpatient deaths suggests persistent vulnerability despite hospital-based thromboprophylaxis strategies. The recent decline in sex-specific rates after 2019 warrants further investigation to determine whether it reflects evolving anticoagulation practices, changes in clinical management, or shifts in cause-of-death reporting.

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