Race, sex, age, and geographic disparities in pancreatic cancer incidence.

520 Background: Pancreatic cancer has a poor prognosis and a 5-year survival rate of 10%. A population-risk level analysis of pancreatic cancer will identify epidemiologic risk factors including geographic, racial, ethnic, and sex inequities which could lead to improved prevention strategies. Methods: Incidence data for invasive pancreatic cancer from 2009 through 2018 was obtained from the Surveillance, Epidemiology, and End Results Research (SEER) Plus Limited-Field database (SEER 21) that covers about 37% of the US population. Age-adjusted incidence rates (AAIR) and trends were estimated by race, sex, age categories (ten-year age groups starting from age 30), and county-level rural-urban classification developed by the United States Department of Agriculture (USDA). Trends over the period are described using the annual percent change (APC) calculated using weighted least squares method. Results: Overall pancreatic cancer incidence (per 100,000 population) for all ages during 2009-2018 was 13.0. Rates were highest among Black (15.4), followed by non-Hispanic white (13.2) and Hispanic (11.6) groups in both men and women. Males carries a higher rate of incidence (14.8) than females (11.6) in pancreatic cancer although both sexes experienced a 0.6% increase in incidence yearly. Incidence of pancreatic cancer increased with age across all ethnicities in men and women. The highest rate of incidence was found in ages 80 and above (99.5) and the lowest in age group 30-39 (1.0). Pancreatic cancer rates increased by 0.6% yearly and increased in every racial/ethnic group for both males and females, except Black males (0.0) and American Indian/Alaska Native females (-0.2). Although incidence in urban counties (13.1, n = 321) and rural counties (12.8, n = 411) was comparable, rural countries observed a faster increase in rates between 2009 and 2018 (p < 0.05). Conclusions: Incidence of pancreatic cancer has increased from 2009 to 2018 across all ethnicities and in both men and women. Minorities, males, and individuals living in rural counties are disproportionately affected by pancreatic cancer. Additionally, older individuals have a higher incidence of pancreatic cancer, suggesting an increased risk in this patient population. This data will inform strategies to identify high-risk populations and implement preventative care, screening, and surveillance.[Table: see text]