Sociodemographic disparities in pancreatic cancer incidence between 2000 and 2022: A Surveillance, Epidemiology and End Results analysis.

Abstract

129 Background: Pancreatic ductal adenocarcinoma (PDAC) presents with significant morbidity and mortality. Five-year survival at 13% consistently remains among the lowest of all cancers. We undertook a population-level risk analysis of sociodemographic risk factors (sex, age, ethnic, and geographic) that may inform closer monitoring of those with increased likelihood of developing PDAC. Methods: PDAC incidence data from 2000 to 2022 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database, representing approximately 37% of the US population. Age-adjusted incidence rates (AAIRs) were calculated by race, sex, age group, and county-level rural–urban classification. Incidence is reported per 100,000 population. Temporal trends were assessed using annual percent change (APC) estimated via weighted least-squares regression. Results: Between 2000 and 2022, the overall AAIR of PDAC was 12.6. Incidence was highest among Black individuals (16.1), followed by White (12.7) and Hispanic (11.7) individuals, and was consistently higher in males (14.3) than in females (11.2). Temporal trends did not differ significantly by sex, with annual increases of +0.8% in males and +0.9% in females. Incidence increased progressively with age across all racial and ethnic groups in both sexes. While overall incidence was comparable between urban and rural counties, rural counties experienced a significantly faster rise in incidence (+1.3% vs. +0.8% APC; p<0.05). Conclusions: PDAC incidence has increased from 2000 to 2022 across both sexes at all ages and across all ethnicities. Those most at risk include males and Black individuals, with rates rising faster in rural counties. Better epidemiological understanding of developing trends of at-risk patients may inform screening strategies for patients at high risk of developing PDAC. Incidence rate (per 100,000 population) and annual change in PDAC (95% CI with Tiwari modification). Rate Trend Sex  Male 14.3 (14.2-14.4) 0.8 (0.7-0.9)  Female 11.2 (11.1-11.3) 0.9 (0.8-1.0) Age  40-44 years 2.7 (2.6-2.8) 1.3 (0.8-1.8)  45-49 years 5.6 (5.4-5.8) 0.8 (0.5-1.1)  50-54 years 10.9 (10.8-11.1) 0.6 (0.4-0.9)  55-59 years 19.2 (19.0-19.5) 1.0 (0.7-1.3)  60-64 years 30.8 (30.0-31.1) 0.8 (0.5-1.0)  65-69 years 45.9 (45.0-46.4) 0.9 (0.7-1.0)  70-74 years 62.2 (62.0-62.8) 0.8 (0.6-0.9)  75-79 years 79.7 (79.0-80.6) 1.0 (0.8-1.2)  80-84 years 94.7 (94.0-95.8) 0.9 (0.7-1.1)  85-89 years 104.6 (103-106.1) 0.8 (0.5-1.1)  90+ years 101.7 (100-103.6) 0.4 (0.1-0.8) Race  White 12.7 (12.6-12.8) 1.1 (1.0-1.2)  Black 16.1 (16-16.3) 0.3 (0.2-0.5)  American Indian/Alaska Native 10.5 (10.0-11.1) 1.4 (0.4-2.4)  Asian or Pacific Islander 10.2 (10.0-10.4) 0.6 (0.4-0.8)  Hispanic 11.7 (11.5-11.8) 0.7 (0.4-0.9) Location  Urban 12.6 (12.5-12.7) 0.8 (0.7-0.9)  Rural 12.6 (12-12.7) 1.3 (1-1.5)