Evolving burden of pancreatic cancer in the Middle East and North Africa Region, 1990–2023: an analysis based on the Global Burden of Disease Study 2023

Abstract

Background Pancreatic cancer is a highly lethal malignancy characterized by an aggressive biological behavior and a narrow therapeutic window, making it a significant public health challenge. In the Middle East and North Africa (MENA) region, monitoring the evolving disease burden is essential for identifying high-risk populations and guiding the allocation of resources for early detection and palliative care. This study provides a longitudinal examination of pancreatic cancer prevalence, mortality, and disability-adjusted life years (DALYs) across the region from 1990 to 2023. Methods Using data from the Global Burden of Disease (GBD) 2023 study, we analyzed the burden of pancreatic cancer across 21 MENA countries. The primary outcomes were age-standardized prevalence, mortality, and DALY rates per 100,000 population. All estimates were age-standardized using the GBD world standard population to ensure comparability. Trends were assessed regionally, sub-regionally, and by sex from 1990 to 2023, with 95% uncertainty intervals (UIs) reported. Results The overall regional age-standardized prevalence of pancreatic cancer increased by 55.9% from 1990 to 2023, rising from 2.38/100,000 to 3.71/100,000. In terms of sex-specific prevalence rates, men had an overall age-standardized prevalence of 4.45/100,000, whereas women had an overall age-standardized prevalence rate of 2.97 per 100,000 in 2023. The same 55.3% increase trend is evidenced by the regional DALY rates (81.82 to 127.07/100,000). When considering rates of prevalence and DALYs by country, there was considerable variability. Egypt and Iraq had the most rapid increases in prevalence of pancreatic cancer (with Egypt’s prevalence being a staggering 238%), while Turkey and Lebanon had the highest overall burdens of pancreatic cancer, and the UAE and Qatar had the largest decreases of prevalence (i.e., UAE dropping by 48%). Afghanistan and Yemen had steady increases in pancreatic cancer since beginning with low rates from 1990. Conclusions The rapidly increasing burden of pancreatic cancer in the MENA region, largely driven by metabolic risk factors and an aging population, necessitates targeted public health strategies. Regional policy should prioritize aggressive primary prevention, specifically tobacco control and metabolic health, alongside the expansion of palliative care services. Furthermore, establishing robust, unified regional cancer registries is critical to improving surveillance and informing health planning.