Global burden of pancreas cancer: regional disparities in incidence, mortality and survival

Introduction
Despite its low incidence, pancreas cancer is one of the most lethal cancers. This study aims to provide a global overview of pancreas cancer as to incidence, mortality and survival, in selected countries of the world.

Methods
Incidence was extracted from CI5plus and NORDCAN. Pancreas cancer deaths and populations were extracted from the WHO mortality database. Age-standardised incidence/mortality rates per 100,000 person-year were computed. Recent mean rates for incidence and mortality and annual percent changes (APC) over the last ten years were computed. Age-standardised relative survival was retrieved from the SEER database, Eurocare-5, NORDCAN and SURVCAN.

Results
Recently, incidence ranged from 2.0 in Uganda to 12.9 in Slovakia in men and from 1.3 in India to 7.3 in Slovakia in women. Mortality rates ranged from 1.3 in Thailand to 10.7 in Estonia in men and from 1.0 in Thailand to 6.7 in Finland in women. Over the last ten years, incidence increased in 21/26 countries in men (APC: –6.09% in Uganda to 4.51% in India) and in 23 countries in women (APC: –5.50% in Costa Rica to 6.51% in India). Increasing mortality trends were observed in 16/30 countries for men (APC: –2.62% in Northern Ireland to 4.73% in Thailand) and in 22 countries for women (APC: –1.27% in Mexico to 4.80% in Thailand). Five-year survival ranged from 3.0% (Northern Ireland) to 17.2% (Hong Kong). Survival trends increased since the 1970’s from less than 5% to nearly 10% in recent years for USA and Northern Europe. Survival by stage indicated better survival for localised cancer with survival reaching 36% in 2010 compared to regional (11%) and distant cancer (3%).

Conclusions
Disparities in pancreas cancer incidence and mortality were observed worldwide. Globally, pancreas cancer survival remained low but increases in one-year relative survival and survival of localised cancer are promising.