Global and registry-based patterns of pancreatic cancer: GLOBOCAN 2020, CI5plus trends (2000–2017), and demographic projections to 2040
Abstract
Background Pancreatic cancer is a highly lethal malignancy for which mortality remains close to incidence. We combined complementary global estimates and longitudinal cancer-registry data to characterize its current burden, recent incidence trends, and demographic implications to 2040. Methods GLOBOCAN 2020 was used for cross-sectional estimates of pancreatic cancer incidence and mortality in 185 countries and territories. Continuous annual incidence trends from 2000 to 2017 were estimated from selected non-overlapping CI5plus registry populations with complete coverage over the study period. Age-standardized rates were calculated using the Segi–Doll world standard population. Log-linear models and continuous segmented regression selected by the Bayesian information criterion were used to estimate annual percentage changes (APCs). IARC Cancer Tomorrow fixed-risk demographic projections were used to estimate incident cases through 2040; annual risk-change scenarios of −0.5% and +0.5% were examined as sensitivity analyses. Results In 2020, an estimated 495,773 pancreatic cancer cases and 466,003 deaths occurred worldwide; the ASIR and ASMR were 4.86 and 4.53 per 100,000, respectively, and the mortality-to-incidence ratio was 0.94. Northern America and Europe had the highest regional ASIRs (8.04 and 7.77), whereas Asia contributed the largest number of cases (233,701). In pooled selected CI5plus populations, incidence increased during 2000–2006 (APC 1.43%, 95% CI 1.27–1.59) and 2006–2017 (APC 1.02%, 95% CI 0.94–1.10). The relative increase was greatest among adults younger than 50 years (APC 1.61%, 95% CI 1.37–1.85), although their absolute rate remained low. Under the fixed-risk demographic scenario, global incident cases were projected to reach 843,772 in 2040, a 70.2% increase from 2020. Conclusion Pancreatic cancer imposes a substantial and geographically unequal burden, with mortality remaining close to incidence. Combining GLOBOCAN with CI5plus distinguishes contemporary global burden from observed registry-based trends and supports risk-based surveillance, registry strengthening, and health-system capacity planning.