title: Pancreatic cancer death rates by race among US men and women, 1970-2009.
abstract: BACKGROUND
  Few studies have examined trends in pancreatic cancer death rates in the United States, and there have been no studies examining recent trends using age-period-cohort analysis.
  
  
  METHODS
  Annual percentage change in pancreatic cancer death rates was calculated for 1970 to 2009 by sex and race among adults aged 35 to 84 years using US mortality data provided by the National Center for Health Statistics and Joinpoint Regression. Age-period-cohort modeling was performed to evaluate the changes in cohort and period effects. All statistical tests were two-sided.
  
  
  RESULTS
  In white men, pancreatic cancer death rates decreased by 0.7% per year from 1970 to 1995 and then increased by 0.4% per year through 2009. Among white women, rates increased slightly from 1970 to 1984, stabilized until the late 1990s, then increased by 0.5% per year through 2009. In contrast, the rates among blacks increased between 1970 and the late 1980s (women) or early 1990s (men) and then decreased thereafter. Age-period-cohort analysis showed that pancreatic cancer death risk was highest for the 1900 to 1910 birth cohort in men and the 1920 to 1930 birth cohort in women and there was a statistically significant increase in period effects since the late 1990s in both white men and white women (two-sided Wald test, P < .001).
  
  
  CONCLUSIONS
  In the United States, whites and blacks experienced opposite trends in pancreatic cancer death rates between 1970 and 2009 that are largely unexplainable by known risk factors. This study underscores the needs for urgent action to curb the increasing trends of pancreatic cancer in whites and for better understanding of the etiology of this disease.
authors.affiliation: Affiliations of authors: Surveillance and Health Services Research program, American Cancer Society (JM, RS, AJ).
authors.forename: Jiemin
authors.initials: J
authors.lastname: Ma
authors.forename: Rebecca
authors.initials: R
authors.lastname: Siegel
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009765:Obesity / Q000150:complications / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*