Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016

Abstract

Background and purpose: The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on pancreatic cancer occurrence and trends in Shanghai. Pancreatic cancer, which has increased the disease burden to the society and patients with their families due to the lack of early symptoms and poor prognosis, remains one of the most common gastrointestinal tumors. This study aimed to analyze the current epidemic status of pancreatic cancer in Shanghai in 2016 and the prevalence trend from 2002 to 2016, and to provide a basis for the prevention and treatment of pancreatic cancer and further research. Methods: Data on pancreatic cancer in Shanghai from 2002 to 2016 were obtained through Shanghai Municipal Center for Disease Control and Prevention Population-based Cancer Registry and Vital Statistics System. In all cases of pancreatic cancer, morphological verification (MV) and non-morphological verification were taken as the highest basis for diagnosis. The number of cases and deaths, crude rates, composition ratios, age-specific rates and cumulative rates were counted according to the year of incidence or death, sex and age groups. Segi’s 1960 world standard population was used to calculate age-standardized rates of incidence and mortality and corresponding truncated age-standardized rate (35-64 years) of pancreatic cancer. Z-test and Cochran test were used to compare the differences of age-specific rates and age-standardized rates among different subgroups, respectively. Temporal trend analyses were conducted by Joinpoint software, and annual percent changes (APCs) were used to describe the trends. Results: In 2016, the MV proportion of new cases of pancreatic cancer in Shanghai was 41.25%, the proportion of cases with death certification only was 0.68%, and the ratio of death to incidence was 0.87. The number of new cases and deaths of pancreatic cancer in Shanghai in 2016 was 2 943 and 2 554, respectively. The crude incidence of pancreatic cancer in Shanghai in 2016 was 20.32/100 000, with an age-standardized incidence of 7.28/100 000. New cases of pancreatic cancer accounted for 3.95% of all malignant tumors, ranking 7 th in the incidence spectrum of malignant tumors. The truncated age-standardized incidence (35-64 years) was 9.53/100 000, and the cumulative incidences for 0-64 years, 0-74 years and 0-84 years were 0.34%, 0.81% and 1.76%, respectively. The crude mortality of pancreatic cancer in Shanghai in 2016 was 17.64/100 000, with an age-standardized mortality of 6.01/100 000. Deaths of pancreatic cancer accounted for 6.90% of all malignant tumor deaths, ranking 5 th in the mortality spectrum of malignant tumors. The truncated age-standardized mortality (35-64 years) was 7.16/100 000, and the cumulative mortalities for 0-64 years, 0-74 years and 0-84 years were 0.26%, 0.64% and 1.57%, respectively. The age-standardized incidence and mortality were significantly higher in men than in women. The age-specific new cases, deaths and rates of pancreatic cancer in Shanghai in 2016 showed an upward trend with increasing age, and the age-specific incidence and mortality peaked at 108.66/100 000 and 106.97/100 000, respectively, among people aged 85 and over. From 2002 to 2016, both the number of new cases and deaths of pancreatic cancer in Shanghai showed a gradual increase trend, of which the number of new cases of pancreatic cancer increased from 1 510 in 2002 to 2 943 in 2016, and the number of deaths increased from 1 458 in 2002 to 2 554 in 2016. Joinpoint analyses showed a significant upward trend in the standardized incidence of pancreatic cancer in Shanghai from 2002 to 2016, with an average annual increase of 0.89% (APC=0.89, t=5.69, P<0.001), while the increase in standardized mortality was not statistically significant. Conclusions: The incidence of pancreatic cancer in Shanghai from 2002 to 2016 showed an upward trend, while the mortality showed a fluctuating trend. Since there is no effective screening tool, a population-based study on the current epidemic status and trend of pancreatic cancer is of great significance for pancreatic cancer prevention and treatment.

Keywords

• |pancreatic cancer|incidence|mortality|trend analysis|shanghai