Global burden and trend of pancreatic cancer in high-income countries: A 30-year analysis of disease dynamics.

Abstract

10549 Background: Pancreatic cancer (PC) has a disproportionately high impact in high-income countries (HIC), where it ranks as the 3rd leading cause of cancer-related deaths, compared to 6th globally. Methods: This study is the first ever systematic analysis estimating the incidence, prevalence, mortality, disability, and associated risk factors of PC across the HIC and its territories from 1990-2021. Using a standardized approach, this analysis examines data by age, sex, year, and location, using insights from the Global Burden of Disease Study 2021. The results are presented in absolute count and age-standardized rate (per 100,000). Results: From 1990-2021, the total prevalence counts increased from 89,475 (95% UI: 85,159–92,609) to 214,254 (95% UI: 192,172–227,351), while deaths rose from 105,828 (95% UI: 99,853–109,660) to 216,444 (95% UI: 193,299–230,784). Concurrently, disability-adjusted life years (DALYs) increased from 2.3 million (95% UI: 2.2–2.3) to 4.1 million (95% UI: 3.8–4.3). Western Europe exhibited the highest regional burden throughout the study period. Nationally, Denmark demonstrated the highest annual percentage change (APC) in the age-standardized incidence rate (ASIR) at 1.34%, followed by France (1.18%), Switzerland (0.85%), Germany (0.82%), and the United States (0.33%). Similarly, the highest APC in the age-standardized mortality rate (ASMR) was observed in Denmark (1.25%), followed by Switzerland (0.78%), France (0.73%), and the United States (0.20%). In 2021, the age group 70–74 years recorded the highest incidence (36,968; 95% UI: 34,001–38,744), mortality (34,990; 95% UI: 32,218–36,771), and DALYs (703,300; 95% UI: 646,488–738,141). Gender-specific analyses revealed that females exhibited a greater burden increase, with APCs of 0.52% in ASIR and 0.30% in ASMR, compared to 0.28% and 0.10%, respectively, in males. Notably, the age-standardized DALY rate (ASDALR) increased by 0.20% in females but decreased by 0.05% in males. Conclusions: Deaths due to PC accounted for 7.77% of all cancer related casualties in 2021 in HIC. The concentration of disease burden in older populations (70–74 years) and the greater increase observed in females compared to males highlight critical demographic and gender-specific disparities. Furthermore, the increase in DALYs, even in regions with stabilizing or declining mortality, calls for enhanced strategies to address long-term disability and improve quality of life. Annual percentage of change in pancreatic cancer from 1990-2021 in high income region, age-standardized rate (per 100,000). High Income Region AAPC (%), 1990-2021,ASIR AAPC (%), 1990-2021,ASMR AAPC (%), 1990-2021,ASDALR Australasia 0.38 0.15 0.01 High-income Asia Pacific 0.42 0.22 -0.01 High-income North America 0.29 0.14 0.04 Southern Latin America -0.08 -0.14 -0.18 Western Europe 0.46 0.27 0.14