DOI: 10.1200/jco.2026.44.19_suppl.129 ISSN: 0732-183X

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

Azmaeen Zarif, Khalid Jazieh

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)

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