Pancreatic cancer mortality is greatest in countries with a high and very high Human Development Index (HDI). The aim was to evaluate the pancreatic cancer mortality rates and trends related to HDI in Brazil by state. An ecological study was conducted on pancreatic cancer mortality in Brazilian states between 1979 and 2019. Age-standardized mortality rates (ASMR) and Annual Average Percent Change (AAPC) were calculated. Pearson´s correlation test was applied to compare rates over the 3 decades

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... rom 1986-2015 to verify correlation between change in HDI from 1991 to 2010. A total of 209,425 deaths from pancreatic cancer were reported in Brazil from 1979 to 2019. In men, ASMRs ranged from 2.9/100,000 in 1979 to 6.1/100,000 in 2019, with AAPC of 1.5% per year, and in women, ASMR ranged from 2.1/100,000 in 1979 to 4.7/100,000 in 2019, with AAPC of 1.9% per year. Mortality rates and trends increase with higher % of HDI improvement with a correlation between ASMRs and HDI above r>0.80. The mortality trends in pancreatic cancer were uneven increase in Brazil, there was an upward trend in mortality in both genders, but higher among women. Pancreatic cancer mortality trends were higher in those states where there was greatest increase in HDI, regions as North and Northeast. However, mortality rates remain higher in South, Southeast and Central-West of Brazil.