Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
PLoS One. 2023 Jul 20;18(7):e0288755. doi: 10.1371/journal.pone.0288755. eCollection 2023.
INTRODUCTION: Pancreatic cancer (PC) is one of the most fatal malignancies, and its incidence and mortality rates are growing annually throughout the world. In this research, we aimed to investigate the time trends and identify the spatial clusters of incidence and mortality on a global scale over the last 30 years, using the Global Burden of Disease (GBD) study 2019 data. METHODS: Age-standardized incidence and mortality data due to PC were extracted from the GBD study, which was carried out from 1990 to 2019. A Joinpoint regression analysis was utilized to examine trends in the incidence and mortality of PC over the past three decades. As such, spatial analyses were undertaken to detect the spatial distribution and clustering of the metrics globally. RESULTS: It was observed that both the incidence and mortality rates were higher in males than in females worldwide. The global mortality and incidence rates significantly increased by 0.8% per year over the time of follow-up period (p<0.05). By spatial cluster analysis for mortality, European and North African countries, as well as Greenland were explored as hot spots; while South African and Southeast Asian countries were explored as cold spots. Regarding incidence, hot spots were found in European countries, Southern America, and Greenland; whilst cold spots were determined in Southern Africa and Madagascar. CONCLUSIONS: Collectively, the temporal trends disclosed a gradual rise in PC incidence and mortality rates over the period 1990-2019, reflecting the global health concern. We further found geographical variations in the patterns and identified high- and low-risk areas for incidence and mortality. These findings facilitate the design and implementation of more resource-efficient and geographically targeted treatments. Given the results of the current study, a practical approach to minimizing the future PC burden involves planned population-wide interventions, as well as primary prevention through healthier lifestyles.
简介:胰腺癌(PC)是最致命的恶性肿瘤之一,其发病率和死亡率在全球范围内呈逐年上升趋势。在这项研究中,我们旨在利用全球疾病负担(GBD)研究 2019 年的数据,调查过去 30 年来全球范围内 PC 的发病率和死亡率的时间趋势,并确定其空间聚集情况。
方法:从 GBD 研究中提取了因 PC 导致的年龄标准化发病率和死亡率数据,该研究于 1990 年至 2019 年进行。采用 Joinpoint 回归分析来检测过去三十年 PC 的发病率和死亡率趋势。因此,进行了空间分析以检测全球范围内这些指标的空间分布和聚类情况。
结果:观察到全球范围内男性的发病率和死亡率均高于女性。在整个随访期间,全球死亡率和发病率每年显著增加 0.8%(p<0.05)。通过死亡率的空间聚类分析,发现欧洲和北非国家以及格陵兰是热点地区;而南非和东南亚国家则是冷点地区。关于发病率,欧洲国家、南美洲和格陵兰是热点地区;而南非和马达加斯加是冷点地区。
结论:总体而言,时间趋势显示 1990-2019 年期间 PC 的发病率和死亡率逐渐上升,反映了全球健康问题。我们还发现了模式的地理差异,并确定了发病率和死亡率的高风险和低风险地区。这些发现有助于设计和实施更具资源效率和针对地理区域的治疗方法。鉴于本研究的结果,通过有计划的人群干预以及通过更健康的生活方式进行初级预防,是减少未来 PC 负担的实用方法。
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