Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2022; 28(32): 4698-4715
Published online Aug 28, 2022. doi: 10.3748/wjg.v28.i32.4698
International patterns in incidence and mortality trends of pancreatic cancer in the last three decades: A joinpoint regression analysis
Irena Ilic, Milena Ilic
Irena Ilic, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
Milena Ilic, Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Author contributions: All authors equally contributed to this paper with conception and design of the study, data acquisition and analysis, interpretation of data, searched the literature, drafting and critical revision and editing, and approval of the final version.
Supported by Ministry of Education, Science and Technological development, Republic of Serbia, 2011-2020, No. 175042.
Institutional review board statement: This study was approved by the Ethics Committee of the Faculty of Medical Sciences, University of Kragujevac (No. 01-14321).
Informed consent statement: The study was conducted using publicly available data. No patient approvals were sought nor required for this study. The data used for inputs and analysis were derived from public sources (such as websites, primarily). Our research question about the international trends in incidence and mortality of pancreatic cancer in last three decades was based on the number of pancreatic cancer cases and deaths in the world in last three decades. Therefore, as our model-based analysis used aggregated (not individually identifiable) data from publicly available sources, patients were not involved in the design, or conduct, or reporting or dissemination plans of the research.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Milena Ilic, MD, PhD, Professor, Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, S. Markovica 69, Kragujevac 34000, Serbia. drmilenailic@yahoo.com
Received: March 2, 2022
Peer-review started: March 2, 2022
First decision: April 12, 2022
Revised: May 5, 2022
Accepted: June 20, 2022
Article in press: June 20, 2022
Published online: August 28, 2022
Processing time: 176 Days and 23.6 Hours
Abstract
BACKGROUND

Pancreatic cancer, as the one of most fatal malignancies, remains a critical issue in the global burden of disease.

AIM

To estimate trends in pancreatic cancer incidence and mortality worldwide in the last three decades.

METHODS

A descriptive epidemiological study was done. Pancreatic cancer incidence and mortality data were obtained from the database of the World Health Organization. Analysis of pancreatic cancer incidence and mortality during 2020 was performed. The age-standardized rates (ASRs, expressed per 100000) were presented. To estimate trends of incidence and mortality of pancreatic cancer, joinpoint regression analysis was used: the average annual percent change (AAPC) with the corresponding 95% confidence interval (95%CI) was calculated. Additionally, analysis was performed by sex and age. In this paper, the trend analysis included only countries with high and medium data quality.

RESULTS

A total of 495773 (262865 male and 232908 female) new cases and 466003 (246840 male and 219163 female) deaths from pancreatic cancer were reported worldwide in 2020. In both sexes, most of the new cases (191348; 38.6% of the total) and deaths (182074; 39.1% of the total) occurred in the Western Pacific Region. In both sexes, the highest ASRs were found in the European Region, while the lowest rates were reported in the South-East Asia Region. The general pattern of rising pancreatic cancer incidence and mortality was seen across countries worldwide in observed period. Out of all countries with an increase in pancreatic cancer incidence, females in France and India showed the most marked rise in incidence rates (AAPC = +3.9% and AAPC = +3.7%, respectively). Decreasing incidence trends for pancreatic cancer were observed in some countries, but without significance. Out of all countries with an increase in pancreatic cancer mortality rates, Turkmenistan showed the most marked rise both in males (AAPC = +10.0%, 95%CI: 7.4–12.5) and females (AAPC = +6.4%, 95%CI: 3.5–9.5). The mortality trends of pancreatic cancer were decreasing in both sexes only in Canada and Mexico.

CONCLUSION

Further research is needed to explain the cause of large international differences in incidence and mortality trends of pancreatic cancer in last three decades.

Keywords: Pancreatic cancer; Incidence; Mortality; Joinpoint analysis; International pattern

Core tip: Pancreatic cancer, as one of the most fatal malignancies, remains a critical issue in global burden of disease. About 500000 new cases and 470000 deaths from pancreatic cancer were recorded in 2020 across the world. Globally, the rate of pancreatic cancer incidence in 2020 was 4.9 per 100000 for both sexes together, while mortality rate was 4.5 per 100000. Increasing trends in both incidence and mortality of pancreatic cancer were observed in most countries across the world. Further efforts to explore the reasons for differences in international pattern in pancreatic cancer incidence and mortality could be critical for global cancer control.