Temporal trends and demographic and geographic disparities in deaths from pancreatic cancer with co-recorded cardiovascular disease in the United States, 1999–2024
Abstract
Objective: To characterize the mortality burden, temporal trends, and demographic and geographic disparities in deaths with pancreatic cancer (PC) as the underlying cause and cardiovascular disease (CVD) co-recorded on the death certificate in the United States during 1999–2024.
Methods: Multiple-cause-of-death data were obtained from the CDC WONDER database. We included US residents aged 25 years or older whose underlying cause of death was malignant neoplasm of the pancreas (ICD-10 code C25) and whose death certificates also recorded CVD (I00–I99). Death counts and age-adjusted mortality rates (AAMRs) with 95% confidence intervals (CIs) were calculated; age-specific crude mortality rates were used for age-group analyses. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs). Analyses covered sex, age, race/ethnicity, region, state, and urbanization. Non-Hispanic racial trends were analysed separately for 1999–2020 and 2018–2024 because race classifications changed.
Results: Of 1,007,392 deaths with PC as the underlying cause, 226,245 (22.5%) had co-recorded CVD. Annual deaths increased from 6,210 to 14,049 (126.2%), and AAMR rose from 3.52 to 4.77 per 100,000 (AAPC, 1.26%; 95% CI, 0.77%–1.75%). APCs were 0.31% during 1999–2018, 6.89% during 2018–2021, and 1.80% during 2021–2024 (95% CI, 0.03%–3.60%). In 2024, AAMR was higher in males than in females (5.75 vs. 3.97). Non-Hispanic Black individuals had the highest numerical AAMR (6.48), whereas non-Hispanic White individuals had the most deaths. During 2018–2024, AAPCs were 4.36% (95% CI, 3.59%–5.14%) and 4.35% (95% CI, 2.77%–5.95%) among non-Hispanic Black and White individuals, respectively. Adults aged 85 years or older had the highest age-specific rate; those aged 75–84 years had the most deaths. The West had the highest AAMR (5.46); the South had the most deaths and largest numerical AAPC (1.93%). During 1999–2020, AAPC was numerically larger in nonmetropolitan areas; their 2020 AAMR was 4.42 versus 4.10 in metropolitan areas.
Conclusions: Population AAMR for deaths with underlying PC and co-recorded CVD increased, with faster growth during 2018–2021. Demographic and geographic variation in recorded mortality supports continued surveillance and further research into cardiovascular comorbidity in PC.
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BibTeX
@article{xue2026temporal,
title = {{Temporal trends and demographic and geographic disparities in deaths from pancreatic cancer with co-recorded cardiovascular disease in the United States, 1999–2024}},
author = {Hanxu Xue and Guangwei Yang and Jianguo Chen and Junfeng Ye},
journal = {BMC Public Health},
year = {2026},
month = nov,
doi = {10.1186/s12889-026-30218-x},
url = {https://link.springer.com/article/10.1186/s12889-026-30218-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Temporal trends and demographic and geographic disparities in deaths from pancreatic cancer with co-recorded cardiovascular disease in the United States, 1999–2024
AU - Hanxu Xue
AU - Guangwei Yang
AU - Jianguo Chen
AU - Junfeng Ye
PY - 2026
DA - 2026/11/05
JO - BMC Public Health
DO - 10.1186/s12889-026-30218-x
UR - https://link.springer.com/article/10.1186/s12889-026-30218-x
AB - Objective: To characterize the mortality burden, temporal trends, and demographic and geographic disparities in deaths with pancreatic cancer (PC) as the underlying cause and cardiovascular disease (CVD) co-recorded on the death certificate in the United States during 1999–2024. Methods: Multiple-cause-of-death data were obtained from the CDC WONDER database. We included US residents aged 25 years or older whose underlying cause of death was malignant neoplasm of the pancreas (ICD-10 code C25) and whose death certificates also recorded CVD (I00–I99). Death counts and age-adjusted mortality rates (AAMRs) with 95% confidence intervals (CIs) were calculated; age-specific crude mortality rates were used for age-group analyses. Joinpoint regression estimated annual percent changes (APCs) and average annual percent changes (AAPCs). Analyses covered sex, age, race/ethnicity, region, state, and urbanization. Non-Hispanic racial trends were analysed separately for 1999–2020 and 2018–2024 because race classifications changed. Results: Of 1,007,392 deaths with PC as the underlying cause, 226,245 (22.5%) had co-recorded CVD. Annual deaths increased from 6,210 to 14,049 (126.2%), and AAMR rose from 3.52 to 4.77 per 100,000 (AAPC, 1.26%; 95% CI, 0.77%–1.75%). APCs were 0.31% during 1999–2018, 6.89% during 2018–2021, and 1.80% during 2021–2024 (95% CI, 0.03%–3.60%). In 2024, AAMR was higher in males than in females (5.75 vs. 3.97). Non-Hispanic Black individuals had the highest numerical AAMR (6.48), whereas non-Hispanic White individuals had the most deaths. During 2018–2024, AAPCs were 4.36% (95% CI, 3.59%–5.14%) and 4.35% (95% CI, 2.77%–5.95%) among non-Hispanic Black and White individuals, respectively. Adults aged 85 years or older had the highest age-specific rate; those aged 75–84 years had the most deaths. The West had the highest AAMR (5.46); the South had the most deaths and largest numerical AAPC (1.93%). During 1999–2020, AAPC was numerically larger in nonmetropolitan areas; their 2020 AAMR was 4.42 versus 4.10 in metropolitan areas. Conclusions: Population AAMR for deaths with underlying PC and co-recorded CVD increased, with faster growth during 2018–2021. Demographic and geographic variation in recorded mortality supports continued surveillance and further research into cardiovascular comorbidity in PC.
SN - 1471-2458
ER -