Background Pancreatic cancer is the third leading cause of cancer-related deaths in the U.S. with rising incidence and mortality rates. Racial and ethnic disparities in pancreatic cancer outcomes in Texas have been underexplored. This study examined incidence and mortality of pancreatic cancer in Texas from 2000–2020.

Methods We conducted a population-based analysis using data from the Texas Cancer Registry to assess incidence and mortality trends in pancreatic cancer by gender and race/ethnicity. Age-adjusted rates were calculated per 100,000 persons. Joinpoint Regression Program identified significant trends and calculated annual percentage change (APC).

Results A total of 58,503 new cases and 48,692 deaths were identified during the study period. Males had higher incidence and mortality rates compared to females (13.9 vs. 10.8 and 11.9 vs. 9.0 per 100,000, respectively). Non-Hispanic Blacks had the highest incidence (16.4 per 100,000) and mortality (13.8 per 100,000) rates. Females demonstrated significantly increasing incidence rates (APC 1.21, p < 0.001) and mortality rates (APC 0.34, p < 0.001) during the study period. Incidence rates increased in Hispanics (APC 0.79, p < 0.001), non-Hispanics blacks (APC 0.45, p = 0.048) and fluctuating in non-Hispanic whites with a significant increase between 2009 -2018 (APC 2.17, p =0.011). Similarly, mortality rates increased in Hispanics (APC 0.78, p < 0.001), non-Hispanic whites (APC 0.63, p <0.05) and non-Hispanic Blacks (APC 0.46, p <0.05).

Conclusions Increasing incidence and mortality trends, particularly among females and Hispanic populations, highlights the urgent need for targeted public health interventions, improved access to care, and early detection strategies.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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Institutional Review Board (IRB) approval was not required for this study. This research utilized data from the Texas Cancer Registry, which is a publicly available, population-based cancer surveillance database containing only de-identified patient information. The Texas Cancer Registry data are considered exempt from human subjects research regulations under 45 CFR 46.104(d)(4) as the research involves the study of existing data that are publicly available and cannot be linked to specific individuals. No direct contact with patients or access to personally identifiable information occurred during this study. The research was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and followed all applicable guidelines for the use of population-based cancer registry data.

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