The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
Gastroenterology. 2021 Feb;160(3):744-754. doi: 10.1053/j.gastro.2020.10.007. Epub 2020 Oct 13.
BACKGROUND & AIMS: We evaluated global and regional burdens of, risk factors for, and epidemiologic trends in pancreatic cancer among groups of different sexes and ages.
We used data from the GLOBOCAN database to estimate pancreatic cancer incidence and mortality in 184 countries. We examined the association between lifestyle and metabolic risk factors, extracted from the World Health Organization Global Health Observatory database, and pancreatic cancer incidence and mortality by univariable and multivariable linear regression. We retrieved country-specific age-standardized rates (ASRs) of incidence and mortalities from cancer registries from 48 countries through 2017 for trend analysis by joinpoint regression analysis.
The highest incidence and mortality of pancreatic cancer were in regions with very high (ASRs, 7.7 and 4.9) and high human development indexes (ASRs, 6.9 and 4.6) in 2018. Countries with higher incidence and mortality were more likely to have higher prevalence of smoking, alcohol drinking, physical inactivity, obesity, hypertension, and high cholesterol. From 2008 to 2017, 2007 to 2016, or 2003 to 2012, depending on the availability of the data, there were increases in incidence among men and women in 14 (average annual percent changes [AAPCs], 8.85 to 0.41) and 17 (AAPCs, 6.04 to 0.87) countries, respectively. For mortality, the increase was observed in 8 (AAPCs, 4.20 to 0.55) countries among men and 14 (AAPCs, 5.83 to 0.78) countries among women. Although the incidence increased in 18 countries (AAPCs, 7.83 to 0.91) among individuals 50 years or older, an increasing trend in pancreatic cancer was also identified among individuals younger than 50 years and 40 years in 8 (AAPCs, 8.75 to 2.82) and 4 (AAPCs, 11.07 to 8.31) countries, respectively.
In an analysis of data from 48 countries, we found increasing incidence and mortality trends in pancreatic cancer, especially among women and populations 50 years or older, but also among younger individuals. More preventive efforts are recommended for these populations.
我们评估了不同性别和年龄组人群的全球和地区胰腺癌负担、风险因素以及流行病学趋势。
我们使用 GLOBOCAN 数据库的数据来估计 184 个国家的胰腺癌发病率和死亡率。我们通过单变量和多变量线性回归检查了生活方式和代谢风险因素（从世界卫生组织全球卫生观测站数据库中提取）与胰腺癌发病率和死亡率之间的关联。我们通过 2017 年之前的 48 个国家的癌症登记处检索了特定国家的发病率和死亡率的年龄标准化率（ASR），并通过 joinpoint 回归分析进行趋势分析。
2018 年，胰腺癌发病率和死亡率最高的地区是人类发展指数极高（ASR 为 7.7 和 4.9）和高（ASR 为 6.9 和 4.6）的地区。发病率和死亡率较高的国家更有可能有更高的吸烟、饮酒、身体活动不足、肥胖、高血压和高胆固醇的流行率。根据数据的可用性，从 2008 年到 2017 年、2007 年到 2016 年或 2003 年到 2012 年，男性和女性的发病率在 14 个（平均年变化百分比 [AAPC]，8.85 至 0.41）和 17 个（AAPC，6.04 至 0.87）国家中均有所上升。死亡率方面，8 个国家（AAPC，4.20 至 0.55）的男性和 14 个国家（AAPC，5.83 至 0.78）的女性的死亡率均有所上升。尽管 18 个国家（AAPC，7.83 至 0.91）50 岁及以上人群的发病率有所增加，但在 8 个国家（AAPC，8.75 至 2.82）和 4 个国家（AAPC，11.07 至 8.31）中，50 岁以下和 40 岁以下人群的胰腺癌发病率也呈上升趋势。
在对来自 48 个国家的数据进行分析后，我们发现胰腺癌的发病率和死亡率呈上升趋势，尤其是在女性和 50 岁及以上人群中，但在年轻人群中也是如此。建议对这些人群采取更多的预防措施。
