Disease burden analysis of pancreatic cancer globally and in China from 1990 to 2021 and future trend projection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

REN Jiadong ¹ , HONG Yun ² , LIU Bin ¹ , MAO Yingying ¹ ,  YE Ding ¹

1. School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053. P. R. China;
2. The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China;

Corresponding author：

YE Ding, Email: yeding@zcmu.edu.cn

Keywords：

pancreatic cancer; disease burden; temporal trends

DOI：

10.7507/1007-9424.202503061

Video：

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Objective To systematically analyze the temporal trends of pancreatic cancer burden in globally and China from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) database and predict disease burden changes over the next 15 years. Methods The data of the incidence, death, disability-adjusted life years (DALYs) and age-standardized rate data of pancreatic cancer in GBD 2021 were extracted to analyze the epidemic status. Joinpoint regression models were employed to calculate average annual percentage changes (AAPC) and identify trend transitions. An auto-regressive integrated moving average (ARIMA) model was utilized to predict disease burden from 2022 to 2036. Results In 2021, the global age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) for pancreatic cancer were 5.96 (per 100 ,000), 5.95 (per 100 000), and 130.33 (per 100 000). Corresponding rates in China were 5.64 (per 100 000), 5.72 (per 100 000), and 137.23 (per 100 000). From 1990 to 2021, the average annual growth rate of ASIR (AAPC=0.72%), ASMR (AAPC=0.56%) and ASDR (AAPC=0.36%) were significantly higher than the global rate (ASIR: AAPC=0.27%; ASMR: AAPC=0.16%; ASDR: AAPC=0.02%). Age-specific analysis shows that the crude incidence, mortality, and DALY rates for the population aged ≥60 years in China (AAPC=0.37%–1.55%) were all increasing at a higher rate than the same age group globally (AAPC=–0.02%–0.77%). Sex differences were significant, with greater disease burden in men than in women. ARIMA model predicted that Chinese and global ASIR and ASMR will continue to rise by 2036, with persistently steeper increases in males than females. Conclusion The disease burden of pancreatic cancer in China is growing faster than that of the world, so early screening and prevention of pancreatic cancer should be strengthened.

1.	易丽夏, 方涵露, 李婧怡, 等. 2022年全球和中国胰腺癌发病及死亡分析. 海军军医大学学报, 2024, 45(12): 1470-1477.
2.	Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2022.
3.	Wang X, Xiu R, Gong L, et al. Unraveling the global burden of inflammatory bowel disease (1990-2019): a Joinpoint regression analysis of divergent trends in 10-24 and 50-69 age cohorts. Autoimmun Rev, 2024, 23(6): 103586.
4.	Jian Y, Zhu D, Zhou D, et al. ARIMA model for predicting chronic kidney disease and estimating its economic burden in China. BMC Public Health, 2022, 22(1): 2456.
5.	杨青龙. 全球与中国2型糖尿病疾病负担的变化模式及预测研究. 成都: 成都医学院, 2024.
6.	Cai J, Chen H, Lu M, et al. Advances in the epidemiology of pancreatic cancer: trends, risk factors, screening, and prognosis. Cancer Lett, 2021, 520: 1-11.
7.	时保国, 吴少龙. “看病难”的空间分析: 嵌入分层理论视角的中国三甲医院地理分布. 甘肃行政学院学报, 2019(5): 94-103,128.
8.	Sun D, Li H, Cao M, et al. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
9.	GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 1989-2056.
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12.	Yang J, Xu R, Wang C, et al. Early screening and diagnosis strategies of pancreatic cancer: a comprehensive review. Cancer Commun (Lond), 2021, 41(12): 1257-1274.
13.	Dbouk M, Katona BW, Brand RE, et al. The multicenter cancer of pancreas screening study: impact on stage and survival. J Clin Oncol, 2022, 40(28): 3257-3266.
14.	Lee SY, Sissoko M, Hartshorn KL. Update on the management of pancreatic cancer in older adults. Curr Oncol Rep, 2016, 18(10): 60.
15.	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.
16.	Zhao H, Zhang Y, Liu H, et al. Age-period-cohort analysis of global, regional, and national pancreatic cancer incidence, mortality, and disability-adjusted life years, 1990-2019. BMC Cancer, 2024, 24(1): 1063.
17.	Amri F, Koulali H, Jabi R, et al. Pancreatic cancer: experience from an emerging country in North Africa. J Cancer Res Clin Oncol, 2023, 149(15): 14297-14302.
18.	唐钧. 世界和中国的人口老龄化及其原因. 社会政策研究, 2022(3): 3-18.
19.	糜跃萍, 胡迪, 蔡波, 等. 1990–2019年江苏省胰腺癌疾病负担和危险因素分析. 疾病监测, 2022, 37(10): 1376-1382.
20.	周聪雅, 金龙, 张苏, 等. 糖脂代谢与胰腺癌患者预后相关性分析. 陕西医学杂志, 2023, 52(9): 1218-1220.
21.	刘永鹏, 张晶晶, 任艳, 等. 1990–2019年中国胰腺癌疾病负担变化趋势研究. 现代预防医学, 2022, 49(17): 3079-3085.
22.	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.
23.	王婷, 秦毅, 徐晓武, 等. 2024年胰腺癌研究及诊疗新进展. 中国癌症杂志, 2025, 35(1): 1-11.
24.	闫明玥, 湛先保, 彭小波. 胰腺癌患者的全程管理. 现代肿瘤医学, 2024, 32(23): 4555-4561.
25.	韩家伟. 胰腺癌新辅助/转化治疗后影响预后临床因素的筛选及预后模型的建立和验证. 中国人民解放军海军军医大学, 2023.
26.	王馨慧, 刘小英, 付文胜. 胰腺癌的中医药治疗研究进展. 中国中西医结合消化杂志, 2022, 30(4): 303-307.
27.	Gram IT, Park SY, Wilkens LR, et al. Smoking and pancreatic cancer: a sex-specific analysis in the multiethnic cohort study. Cancer Causes Control, 2023, 34(1): 89-100.
28.	Zhao Z, Liu W. Pancreatic cancer: a review of risk factors, diagnosis, and treatment. Technol Cancer Res Treat, 2020, 19: 1533033820962117.

1. 易丽夏, 方涵露, 李婧怡, 等. 2022年全球和中国胰腺癌发病及死亡分析. 海军军医大学学报, 2024, 45(12): 1470-1477.
2. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2022.
3. Wang X, Xiu R, Gong L, et al. Unraveling the global burden of inflammatory bowel disease (1990-2019): a Joinpoint regression analysis of divergent trends in 10-24 and 50-69 age cohorts. Autoimmun Rev, 2024, 23(6): 103586.
4. Jian Y, Zhu D, Zhou D, et al. ARIMA model for predicting chronic kidney disease and estimating its economic burden in China. BMC Public Health, 2022, 22(1): 2456.
5. 杨青龙. 全球与中国2型糖尿病疾病负担的变化模式及预测研究. 成都: 成都医学院, 2024.
6. Cai J, Chen H, Lu M, et al. Advances in the epidemiology of pancreatic cancer: trends, risk factors, screening, and prognosis. Cancer Lett, 2021, 520: 1-11.
7. 时保国, 吴少龙. “看病难”的空间分析: 嵌入分层理论视角的中国三甲医院地理分布. 甘肃行政学院学报, 2019(5): 94-103,128.
8. Sun D, Li H, Cao M, et al. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
9. GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 1989-2056.
10. Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol, 2016, 22(44): 9694-9705.
11. McGuigan A, Kelly P, Turkington RC, et al. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol, 2018, 24(43): 4846-4861.
12. Yang J, Xu R, Wang C, et al. Early screening and diagnosis strategies of pancreatic cancer: a comprehensive review. Cancer Commun (Lond), 2021, 41(12): 1257-1274.
13. Dbouk M, Katona BW, Brand RE, et al. The multicenter cancer of pancreas screening study: impact on stage and survival. J Clin Oncol, 2022, 40(28): 3257-3266.
14. Lee SY, Sissoko M, Hartshorn KL. Update on the management of pancreatic cancer in older adults. Curr Oncol Rep, 2016, 18(10): 60.
15. 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.
16. Zhao H, Zhang Y, Liu H, et al. Age-period-cohort analysis of global, regional, and national pancreatic cancer incidence, mortality, and disability-adjusted life years, 1990-2019. BMC Cancer, 2024, 24(1): 1063.
17. Amri F, Koulali H, Jabi R, et al. Pancreatic cancer: experience from an emerging country in North Africa. J Cancer Res Clin Oncol, 2023, 149(15): 14297-14302.
18. 唐钧. 世界和中国的人口老龄化及其原因. 社会政策研究, 2022(3): 3-18.
19. 糜跃萍, 胡迪, 蔡波, 等. 1990–2019年江苏省胰腺癌疾病负担和危险因素分析. 疾病监测, 2022, 37(10): 1376-1382.
20. 周聪雅, 金龙, 张苏, 等. 糖脂代谢与胰腺癌患者预后相关性分析. 陕西医学杂志, 2023, 52(9): 1218-1220.
21. 刘永鹏, 张晶晶, 任艳, 等. 1990–2019年中国胰腺癌疾病负担变化趋势研究. 现代预防医学, 2022, 49(17): 3079-3085.
22. 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.
23. 王婷, 秦毅, 徐晓武, 等. 2024年胰腺癌研究及诊疗新进展. 中国癌症杂志, 2025, 35(1): 1-11.
24. 闫明玥, 湛先保, 彭小波. 胰腺癌患者的全程管理. 现代肿瘤医学, 2024, 32(23): 4555-4561.
25. 韩家伟. 胰腺癌新辅助/转化治疗后影响预后临床因素的筛选及预后模型的建立和验证. 中国人民解放军海军军医大学, 2023.
26. 王馨慧, 刘小英, 付文胜. 胰腺癌的中医药治疗研究进展. 中国中西医结合消化杂志, 2022, 30(4): 303-307.
27. Gram IT, Park SY, Wilkens LR, et al. Smoking and pancreatic cancer: a sex-specific analysis in the multiethnic cohort study. Cancer Causes Control, 2023, 34(1): 89-100.
28. Zhao Z, Liu W. Pancreatic cancer: a review of risk factors, diagnosis, and treatment. Technol Cancer Res Treat, 2020, 19: 1533033820962117.

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