P2184 - Unraveling the Link: 25-Year Trends in Pancreatic Cancer Mortality Among U.S. Adults Aged 55 and Older With Metabolic Syndrome

Simran Joshi, MD¹, Corinne Caissie, MD¹, Muhammad Faizan Ali, MD², Husnain Ahmad, MBBS³, Ali Hassan, MBBS³, Muhammad Khan, MBBS⁴, Matthew Antony. Manoj, MBBS⁵, Sherif Eltawansy, MD⁶, Marquise Soto, MD⁷, Saman Javaid, MBBS⁸, Jeevin Singh Sandhu, DO⁹, Noor ul Ain Saleem, ¹⁰, Mohammad Islam, MD¹¹, Cheng-Hung Tai, MD¹
1Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT; 2Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan; 3Shalamar Institute of Health Sciences, Lahore, Punjab, Pakistan; 4Bacha Khan Medical College, Mardan, Punjab, Pakistan; 5Beth Israel Deaconess Medical Center, Boston, MA; 6Jersey Shore University Medical Center, Jersey Shore, NJ; 7Massachusetts General Hospital, Chelsea, MA; 8CMH Kharian, Sarghoda, Punjab, Pakistan; 9Methodist Dallas Medical Center, Dallas, TX; 10Fatima Memorial Hospital, Lahore, Punjab, Pakistan; 11Yale New Haven Health, Bridgeport, CT

Introduction: Pancreatic cancer (PC) remains one of the deadliest malignancies in the U.S., with rising incidence and mortality rates, particularly among older adults. Metabolic syndrome (MetS)—a cluster of conditions including hypertension, hyperglycemia, dyslipidemia, and central obesity—has emerged as a significant risk factor for both the development and progression of PC. The pro-inflammatory and insulin-resistant state induced by MetS may accelerate tumorigenesis and worsen outcomes. Despite this biological plausibility, national-level mortality trends in patients with comorbid MetS remain poorly characterized. This study aims to evaluate 25-year trends in PC–related mortality among U.S. adults aged ≥55 years with MetS, highlighting demographic disparities and emerging patterns.

Methods: Mortality data was obtained from CDC WONDER using ICD-10 codes for PC and MetS. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression assessed Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Trends were analyzed by sex, age, race/ethnicity, region, urbanization, and state. Statistical significance was set at p < 0.05.

Results: There were 113,379 deaths attributed to comorbid PC and MetS in adults ≥55, with 46% occurring at home. The overall AAMR rose 107% from 4.12 (1999) to 8.51 (2023) (AAPC: 2.9%, 95% CI: 2.7–3.1, p < 0.000001). Men had higher AAMRs than women (6.8 vs 4.9) and a steeper increase (AAPC: 3.2% vs 2.6%). Non-Hispanic (NH) Blacks had the highest AAMR (8.76), while NH Whites had the steepest rise (AAPC: 3.52%, 95% CI: 3.23–3.90). Adults 75+ had nearly four times the AAMR of those 55–74 (11.95 vs 3.42), though the younger group had a faster rise (AAPC: 3.1% vs 2.8%).The West had the highest AAMR (6.23), while the South had the steepest increase (AAPC: 4.23%, 95% CI: 3.74–4.88). Rural areas had higher AAMRs than urban (6.02 vs 5.27) and a faster increase (AAPC: 3.1%, 95% CI: 2.7–3.7). Nebraska, Mississippi, Oklahoma, Maryland, and Minnesota ranked in the top 90th percentile of mortality burden.

Discussion: Mortality from PC and MetS in older adults has doubled over two decades, with significant disparities by sex, age, race, and geography. The sharper rise in rural, Southern populations, and NH Whites, calls for targeted public health strategies, improved access to care, and earlier risk identification to curb this growing burden.


Figure: Trends in pancreatic cancer mortality among U.S adults aged 55 and older with metabolic syndrome


Figure: Central illustration of pancreatic cancer mortality among U.S adults aged 55 and older with metabolic syndrome

Disclosures:
Simran Joshi indicated no relevant financial relationships.
Corinne Caissie indicated no relevant financial relationships.
Muhammad Faizan Ali indicated no relevant financial relationships.
Husnain Ahmad indicated no relevant financial relationships.
Ali Hassan indicated no relevant financial relationships.
Muhammad Khan indicated no relevant financial relationships.
Matthew Manoj indicated no relevant financial relationships.
Sherif Eltawansy indicated no relevant financial relationships.
Marquise Soto indicated no relevant financial relationships.
Saman Javaid indicated no relevant financial relationships.
Jeevin Singh Sandhu indicated no relevant financial relationships.
Noor ul Ain Saleem indicated no relevant financial relationships.
Mohammad Islam indicated no relevant financial relationships.
Cheng-Hung Tai indicated no relevant financial relationships.

Simran Joshi, MD¹, Corinne Caissie, MD¹, Muhammad Faizan Ali, MD², Husnain Ahmad, MBBS³, Ali Hassan, MBBS³, Muhammad Khan, MBBS⁴, Matthew Antony. Manoj, MBBS⁵, Sherif Eltawansy, MD⁶, Marquise Soto, MD⁷, Saman Javaid, MBBS⁸, Jeevin Singh Sandhu, DO⁹, Noor ul Ain Saleem, ¹⁰, Mohammad Islam, MD¹¹, Cheng-Hung Tai, MD¹. P2184 - Unraveling the Link: 25-Year Trends in Pancreatic Cancer Mortality Among U.S. Adults Aged 55 and Older With Metabolic Syndrome, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.