Trends and disparities for co-existent pancreatic cancer and cardiovascular-related deaths: a retrospective 1999–2020 analysis of CDC WONDER data

Pancreatic cancer and cardiovascular disease are among the leading causes of death in the U.S. and may co-occur with compounding effects. This study assesses trends in mortality rates for comorbid pancreatic cancer and cardiovascular disease, along with sociodemographic disparities to better inform public health and policy efforts.

A retrospective cohort study was conducted using CDC WONDER data between 1999 and 2020. Mortality for pancreatic cancer was assessed using ICD-10 code C25 with I00-I99 for any cardiovascular-related death. Joinpoint regression software was used to assess mortality trends overall and across strata of race, sex, and urbanization status. Age-adjusted mortality rate (AAMR) per 1,000,000 was examined on a year-by-year and demographic basis by assessing annual percent change (APC) with confidence intervals and p-values.

Between 1999 and 2020, 189,463 deaths were associated with both cardiovascular death and pancreatic cancer. Overall age-adjusted mortality rate (AAMR) per 1,000,000 increased from 26.164 in 1999 to 31.478 in 2020 (APC = 0.85%, CI = 0.72–0.98%, p < 10⁻⁶). Males consistently had higher mortality rates than females, with both groups showing significant increases (APC_male=0.86%, APC_female=0.94%, p < 10⁻⁶). White individuals had higher absolute mortality rates, whereas Black/African-American individuals demonstrated a greater relative increase over time (APC = 1.38% vs. 1.10%; p < 10⁻⁶ for both). Metropolitan residents had consistently lower mortality rates than non-metropolitan residents, but metropolitan residents experienced a sharper increase (APC_metro=0.84%, APC_non−metro=0.63%, p < 10⁻⁶).

Pancreatic cancer-associated cardiovascular mortality has consistently increased in the United States from 1999 to 2020. There were notable demographic disparities which could provide insight towards targeted interventions for long-term mortality decrease.