Temporal Trends and Structural Acceleration in Nutritionand Cachexia-Associated Mortality Among Pancreatic Cancer Decedents in the United States, 1999–2020: A Nationwide Population-Based Joinpoint Analysis
Galip Can Uyar1, Kadriye Başkurt1, Enes Yeşilbaş1, Hayriye Şahinli1, Ömür Berna Çakmak Öksüzoğlu1, Osman Sütcüoğlu21Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, Türkiye, 2Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Türkiye
Objectives: Cancer cachexia contributes substantially to morbidity and mortality in pancreatic cancer (PC), but nationwide mortality data remain limited. We evaluated temporal trends in nutrition- and cachexia-associated mortality among U.S. PC decedents from 1999 to 2020. Methods: This nationwide study used the CDC WONDER Multiple Cause of Death database. PC deaths were identified by ICD-10 code C25; nutrition- and cachexia-associated mortality was defined by contributing-cause codes R64, E43, E44, and E46. Temporal trends were assessed using joinpoint regression. Results: Among 810,481 PC deaths, 11,830 (1.46%) had nutrition- or cachexia-related conditions recorded as contributing causes. A significant inflection occurred in 2013. Mortality decreased during 1999–2013 (APC, ?0.79%; 95% CI, ?1.28 to ?0.29; p=0.002) and increased during 2013–2020 (APC, 13.53%; 95% CI, 12.52–14.55; p<0.001). Mortality was higher among males (MRR, 1.10; 95% CI, 1.06–1.14; p<0.001), and 72.6% of deaths occurred in individuals aged ?65 years. Only 5.0% occurred in hospice facilities. Conclusion: Documented nutrition- and cachexia-associated mortality increased markedly after 2013, particularly among older adults and males. This death-certificate-based inflection is hypothesis-generating and may partly reflect changes in clinical recognition and coding practices. Keywords: Cachexia, Mortality, Pancreatic cancer, Temporal trends, United States
Cite This Article
Uyar G, Başkurt K, Yeşilbaş E, Şahinli H, Çakmak Öksüzoğlu Ö, Sütcüoğlu O. Temporal Trends and Structural Acceleration in Nutritionand Cachexia-Associated Mortality Among Pancreatic Cancer Decedents in the United States, 1999–2020: A Nationwide Population-Based Joinpoint Analysis. EJMI. 2026; 10(3): 441-448
Corresponding Author: Galip Can Uyar