Burden and future trajectory of pancreatic cancer in the EU-28, 1990-2023: A GBD 2023 analysis with projections to 2050.
BACKGROUND Pancreatic cancer is a highly lethal malignancy with a growing burden in aging populations. Updated evidence on the long-term burden and future trajectory of pancreatic cancer in the European Union (EU) remains limited. METHODS Using Global Burden of Disease (GBD) 2023 estimates, we assessed incidence, deaths, disability-adjusted life-years (DALYs), and prevalence for pancreatic cancer in the pre-Brexit EU-28 from 1990 to 2023. Absolute numbers and age-standardised rates (ASRs) were analyzed by year, sex, age group, country, and European subregion. Estimated annual percentage changes and joinpoint regression quantified temporal trends. Projections to 2050 were generated using exponential smoothing state-space models. RESULTS From 1990 to 2023, incident cases increased from 55,846 to 108,430, deaths from 55,649 to 105,272, and DALYs from 1226,259 to 2050,685, whereas ASRs increased more modestly. Males had higher burden in 2023, but female ASRs increased faster (incidence EAPC: 0.69% vs. 0.30%). Individuals aged ≥60 years accounted for >87% of cases. Finland, Denmark, Germany, Czechia, Hungary, and Latvia showed consistently high burden. By 2050, incident cases and deaths are projected to reach 142,765 and 138,080, respectively, with only modest increases in ASRs. CONCLUSIONS Pancreatic cancer burden in the EU has increased substantially and is projected to continue rising through 2050. Demographic change, particularly population ageing, contributes importantly to this growing burden, emphasizing the need for age-adapted and equitable cancer control strategies.