CDC analysis of pancreatic cancer and diabetes-associated pancreatic cancer mortality among older adults (1999-2020).

e16447 Background: Pancreatic cancer is a major cause of cancer related mortality in the United States. New-onset diabetes occurring one to three years before diagnosis may serve as an early clinical marker of pancreatic cancer, while long-standing diabetes is an established risk factor for disease development. Despite these known associations, mortality trends in individuals with diabetes associated pancreatic cancer remain poorly characterized. Understanding long-term mortality trends in this population is essential to inform public health strategies and guide clinical practice. Methods: Mortality data were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2020, including individuals aged ≥55 years identified using ICD-10 codes. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percentage change (APC) were calculated and stratified by sex, race/ethnicity, and geographic region. Statistical significance was defined as p <0.05. Results: From 1999 to 2020, a total of 775,072 deaths were attributed to pancreatic cancer (PC), with age-adjusted mortality rates (AAMRs) increasing from 46.9 to 50.0 per 100,000 population. Among these, 57,777 deaths were attributed to diabetes-associated pancreatic cancer (DM-PC), with AAMRs rising from 3.1 to 4.5. DM-PC AAMRs peaked between 2018 and 2020, demonstrating a significant increase (APC: 9.03; 95% CI: 5.86–11.00; p <0.01). Men exhibited higher AAMRs than women for both PC and DM-PC. PC-related AAMRs were highest among non-Hispanic African American and non-Hispanic white populations, whereas DM-PC AAMRs were highest among African American and Hispanic populations. Regionally, PC AAMRs were highest in the Northeast, while DM-PC AAMRs were highest in the West. Urban areas demonstrated higher AAMRs for PC, whereas rural areas consistently exhibited higher AAMRs for DM-PC. Conclusions: DM-PC mortality increased significantly over the past two decades, disproportionately affecting men, African Americans, Hispanics, and population from the West. These findings highlight the importance of early clinical recognition of DM-PC to reduce avoidable deaths and guide future resource allocation.