Epidemiological status and trends of pancreatic cancer globally and in China_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GUO Qiang , HUANG Xing , XIA Ning ,  TIAN Bole

Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

TIAN Bole, Email: hxtbl0338@163.com

Keywords：

pancreatic cancer; global estimate; China estimate; incidence rate; mortality; GLOBOCAN 2022

DOI：

10.7507/1007-9424.202504058

Video：

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Objective To systematically analyze the incidence and mortality of pancreatic cancer globally and in China from 2018–2022 based on GLOBOCAN 2018, 2020, and 2022 editions released by the International Agency for Research on Cancer, and summarize the main influencing factors to provide reference for the formulation of prevention and control strategies and clinical practice of pancreatic cancer in China. Methods We collected and organized data on pancreatic cancer incidence cases, mortality cases, crude incidence rate, crude mortality rate, age-standardized incidence rate by world standard population (ASIRW), and age-standardized mortality rate by world standard population (ASMRW) from the GLOBOCAN database. Combined with socioeconomic parameters such as human development index (HDI) and national income levels, we conducted comparative analysis of the distribution characteristics of pancreatic cancer globally and in China across different regions, age groups, and genders. Results From 2018 to 2022, incidence number of global pancreatic cancer increased from 458 000 cases i to 511 000 cases in 2022, with crude incidence rate rising from 5.4/100 000 to 6.5/100 000. Deaths increased from 432 000 cases to 467 000 cases, with crude mortality rising from 5.7/100 000 to 5.9/100 000, while ASMRW decreased from 4.4/100 000 to 4.3/100 000. In China, incidence number of pancreatic cancer increased from 116 000 cases in 2018 to 119 000 cases in 2022, accounting for 23.3% of global cases, with crude incidence rate maintained at (8–9)/100 000. Deaths decreased from 110 000 cases to 106 000 cases, with crude mortality declining from 7.8/100 000 to 7.5/100 000 and ASMRW decreasing from 4.9/100 000 to 3.9/100 000. In 2022, countries with very high HDI had pancreatic cancer ASIRW of 7.9/100 000 and ASMRW of 6.9/100 000, significantly higher than low HDI countries at 1.4/100 000. Pancreatic cancer incidence showed clear age-related patterns, with the ≥75 age group having 191 157 new cases globally (crude incidence rate of 63.3/100 000) and 37 722 cases in China (crude incidence rate of 51.2/100 000). Both globally and in China, males showed higher incidence rate and mortality than females. Conclusions Pancreatic cancer is becoming an important public health challenge globally and in China, with incidence rate and mortality likely to continue rising in the future. Comprehensive prevention and control measures including tobacco control, obesity management, and diabetes monitoring should be strengthened. Early screening and standardized diagnosis and treatment for high-risk populations are crucial for improving pancreatic cancer survival rates. Improving the national cancer registry system and integrating multidisciplinary collaborative models can lay a solid foundation for precision prevention and treatment of pancreatic cancer.

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2.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
4.	Rahib L, Smith BD, Aizenberg R, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res, 2014, 74(11): 2913-2921.
5.	Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
6.	Xu Y, Liu W, Long Z, et al. Mortality and years of life lost due to pancreatic cancer in China, its provinces, urban and rural areas from 2005 to 2020: results from the national mortality surveillance system. BMC Cancer, 2023, 23(1): 893.
7.	Klein AP. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol, 2021, 18(7): 493-502.
8.	Li Y, Teng D, Shi X, et al. Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: two national cross-sectional surveys. Lancet Reg Health West Pac, 2021, 15: 100227.
9.	Xu Y, Lu J, Li M, et al. Diabetes in China part 1: epidemiology and risk factors. Lancet Public Health, 2024, 9(12): e1089-e1097.
10.	Strobel O, Lorenz P, Hinz U, et al. Actual five-year survival after upfront resection for pancreatic ductal adenocarcinoma: who beats the odds? Ann Surg, 2022, 275(5): 962-971.
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12.	Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
13.	GBD 2017 Pancreatic Cancer Collaborators. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol, 2019, 4(12): 934-947.
14.	Veisani Y, Jenabi E, Khazaei S, et al. Global incidence and mortality rates in pancreatic cancer and the association with the human development index: decomposition approach. Public Health, 2018, 156: 87-91.
15.	Aune D, Greenwood DC, Chan DS, et al. Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol, 2012, 23(4): 843-852.
16.	Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol, 2019, 10(1): 10-27.
17.	Iodice S, Gandini S, Maisonneuve P, et al. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbecks Arch Surg, 2008, 393(4): 535-545.
18.	Fuchs CS, Colditz GA, Stampfer MJ, et al. A prospective study of cigarette smoking and the risk of pancreatic cancer. Arch Intern Med, 1996, 156(19): 2255-2260.
19.	Ye W, Lagergren J, Weiderpass E, et al. Alcohol abuse and the risk of pancreatic cancer. Gut, 2002, 51(2): 236-239.
20.	Hu JX, Zhao CF, Chen WB, et al. Pancreatic cancer: a review of epidemiology, trend, and risk factors. World J Gastroenterol, 2021, 27(27): 4298-4321.
21.	Lynch SM, Vrieling A, Lubin JH, et al. Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium. Am J Epidemiol, 2009, 170(4): 403-413.
22.	Eibl G, Rozengurt E. Obesity and pancreatic cancer: insight into mechanisms. Cancers (Basel), 2021, 13(20): 5067.
23.	Scully T, Ettela A, LeRoith D, et al. Obesity, type 2 diabetes, and cancer risk. Front Oncol, 2021, 10: 615375.
24.	Wang F, Herrington M, Larsson J, et al. The relationship between diabetes and pancreatic cancer. Mol Cancer, 2003, 2: 4.
25.	Yuan C, Kim J, Wang QL, et al. The age-dependent association of risk factors with pancreatic cancer. Ann Oncol, 2022, 33(7): 693-701.
26.	Ben Q, Xu M, Ning X, et al. Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies. Eur J Cancer, 2011, 47(13): 1928-1937.
27.	中华医学会消化内镜学分会胰腺疾病协作组. 中国胰腺癌高危人群早期筛查和监测共识意见 (2021, 南京). 临床肝胆病杂志, 2022, 38(5): 1016-1022.
28.	Canto MI, Harinck F, Hruban RH, et al. International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut, 2013, 62(3): 339-347.
29.	Zhang T, Wu W, Yang Y, et al. The Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020). J Pancreatol, 2021, 4(4): 135-145.
30.	Neoptolemos JP, Kleeff J, Michl P, et al. Therapeutic developments in pancreatic cancer: current and future perspectives. Nat Rev Gastroenterol Hepatol, 2018, 15(6): 333-348.
31.	Park W, Chawla A, O'Reilly EM. Pancreatic cancer: a review. JAMA, 2021, 326(9): 851-862.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
4. Rahib L, Smith BD, Aizenberg R, et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res, 2014, 74(11): 2913-2921.
5. Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
6. Xu Y, Liu W, Long Z, et al. Mortality and years of life lost due to pancreatic cancer in China, its provinces, urban and rural areas from 2005 to 2020: results from the national mortality surveillance system. BMC Cancer, 2023, 23(1): 893.
7. Klein AP. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol, 2021, 18(7): 493-502.
8. Li Y, Teng D, Shi X, et al. Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: two national cross-sectional surveys. Lancet Reg Health West Pac, 2021, 15: 100227.
9. Xu Y, Lu J, Li M, et al. Diabetes in China part 1: epidemiology and risk factors. Lancet Public Health, 2024, 9(12): e1089-e1097.
10. Strobel O, Lorenz P, Hinz U, et al. Actual five-year survival after upfront resection for pancreatic ductal adenocarcinoma: who beats the odds? Ann Surg, 2022, 275(5): 962-971.
11. 柯能文, 刘续宝. 胰腺癌外科治疗华西10年经验. 中国普外基础与临床杂志, 2021, 28(1): 4-7.
12. Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent, 2024, 4(1): 47-53.
13. GBD 2017 Pancreatic Cancer Collaborators. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol, 2019, 4(12): 934-947.
14. Veisani Y, Jenabi E, Khazaei S, et al. Global incidence and mortality rates in pancreatic cancer and the association with the human development index: decomposition approach. Public Health, 2018, 156: 87-91.
15. Aune D, Greenwood DC, Chan DS, et al. Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol, 2012, 23(4): 843-852.
16. Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol, 2019, 10(1): 10-27.
17. Iodice S, Gandini S, Maisonneuve P, et al. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbecks Arch Surg, 2008, 393(4): 535-545.
18. Fuchs CS, Colditz GA, Stampfer MJ, et al. A prospective study of cigarette smoking and the risk of pancreatic cancer. Arch Intern Med, 1996, 156(19): 2255-2260.
19. Ye W, Lagergren J, Weiderpass E, et al. Alcohol abuse and the risk of pancreatic cancer. Gut, 2002, 51(2): 236-239.
20. Hu JX, Zhao CF, Chen WB, et al. Pancreatic cancer: a review of epidemiology, trend, and risk factors. World J Gastroenterol, 2021, 27(27): 4298-4321.
21. Lynch SM, Vrieling A, Lubin JH, et al. Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium. Am J Epidemiol, 2009, 170(4): 403-413.
22. Eibl G, Rozengurt E. Obesity and pancreatic cancer: insight into mechanisms. Cancers (Basel), 2021, 13(20): 5067.
23. Scully T, Ettela A, LeRoith D, et al. Obesity, type 2 diabetes, and cancer risk. Front Oncol, 2021, 10: 615375.
24. Wang F, Herrington M, Larsson J, et al. The relationship between diabetes and pancreatic cancer. Mol Cancer, 2003, 2: 4.
25. Yuan C, Kim J, Wang QL, et al. The age-dependent association of risk factors with pancreatic cancer. Ann Oncol, 2022, 33(7): 693-701.
26. Ben Q, Xu M, Ning X, et al. Diabetes mellitus and risk of pancreatic cancer: a meta-analysis of cohort studies. Eur J Cancer, 2011, 47(13): 1928-1937.
27. 中华医学会消化内镜学分会胰腺疾病协作组. 中国胰腺癌高危人群早期筛查和监测共识意见 (2021, 南京). 临床肝胆病杂志, 2022, 38(5): 1016-1022.
28. Canto MI, Harinck F, Hruban RH, et al. International Cancer of the Pancreas Screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut, 2013, 62(3): 339-347.
29. Zhang T, Wu W, Yang Y, et al. The Chinese guidelines for neoadjuvant therapy of pancreatic cancer (2020). J Pancreatol, 2021, 4(4): 135-145.
30. Neoptolemos JP, Kleeff J, Michl P, et al. Therapeutic developments in pancreatic cancer: current and future perspectives. Nat Rev Gastroenterol Hepatol, 2018, 15(6): 333-348.
31. Park W, Chawla A, O'Reilly EM. Pancreatic cancer: a review. JAMA, 2021, 326(9): 851-862.

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