Xia Zeyu, Han Wenping, Niu Haigang, Dong Hui
People's Hospital of Yiyang, Yiyang 413001, China.
Teaching and Research Section of Surgery, Faculty of Clinical Medicine, Fenyang College, Shanxi Medical University, Fenyang 032200, China.
Cancers (Basel). 2025 May 23;17(11):1757. doi: 10.3390/cancers17111757.
Pancreatic cancer (PC), the third leading cause of cancer-related mortality globally, exhibits a persistently low five-year survival rate (13%). While the global burden of PC among individuals aged 15-59 years has declined, trends in China remain understudied. This study evaluates global and national trends in PC incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021 and projects trajectories to 2045.
Using data from the Global Burden of Disease (GBD) 2021 study, we calculated age-standardized rates (ASRs) for 204 countries/territories. Joinpoint (version: 5.3.0.0) regression identified temporal trends via average annual percentage changes (AAPCs), and Bayesian age-period-cohort (BAPC) modeling forecasted future burdens.
Globally, PC burden declined among 15-59-year-olds (AAPC for incidence: -0.8%, 95% UI: -1.2 to -0.4). However, China experienced a significant reversal after 2009, with incidence rising by 1.5% annually (95% UI: 0.9-2.1), disproportionately affecting males. Smoking (contributing to 22.2% of DALYs in China) and high fasting plasma glucose (15%) emerged as key modifiable risk factors, while elevated BMI exacerbated burdens in high SDI regions (3.1% of DALYs). Projections indicate a continued surge in China's PC burden by 2045, particularly among males (incidence projected to increase by 50% from 2010 to 2045).
High SDI regions exhibit concentrated PC burdens linked to lifestyle factors, whereas China's rising trends align with healthcare expansion and metabolic disease proliferation. Targeted interventions-smoking cessation, glycemic control, and weight management-are imperative to mitigate growing burdens in younger populations. This study highlights the urgent need for region-specific strategies to address evolving epidemiological challenges in PC prevention and control.
胰腺癌（PC）是全球癌症相关死亡的第三大主要原因，其五年生存率一直很低（13%）。虽然15至59岁人群中胰腺癌的全球负担有所下降，但中国的趋势仍研究不足。本研究评估了1990年至2021年全球和中国胰腺癌发病率、死亡率及伤残调整生命年（DALYs）的趋势，并预测了到2045年的发展轨迹。
利用全球疾病负担（GBD）2021研究的数据，我们计算了204个国家/地区的年龄标准化率（ASRs）。Joinpoint（版本：5.3.0.0）回归通过年均百分比变化（AAPCs）确定时间趋势，贝叶斯年龄-时期-队列（BAPC）模型预测未来负担。
在全球范围内，15至59岁人群的胰腺癌负担有所下降（发病率的AAPC为-0.8%，95%可信区间：-1.2至-0.4）。然而，中国在2009年后出现了显著逆转，发病率每年上升1.5%（95%可信区间：0.9-2.1），对男性的影响尤为严重。吸烟（在中国DALYs中占22.2%）和高空腹血糖（15%）成为关键的可改变风险因素，而高体重指数在高社会人口指数（SDI）地区加剧了负担（占DALYs的3.1%）。预测表明，到2045年中国胰腺癌负担将持续激增，尤其是在男性中（预计发病率从2010年到2045年将增加50%）。
高SDI地区的胰腺癌负担集中与生活方式因素有关，而中国的上升趋势与医疗保健扩张和代谢性疾病增多相一致。有针对性的干预措施——戒烟、血糖控制和体重管理——对于减轻年轻人群不断增加的负担至关重要。本研究强调迫切需要针对特定区域的策略来应对胰腺癌预防和控制中不断演变的流行病学挑战。
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