Shifting epidemiology of pancreatic cancer in Southeast Spain (1983-2018): emerging patterns in younger women and neuroendocrine neoplasms

Abstract

BACKGROUND: Pancreatic cancer (PC) is among the most lethal cancers, with increasing incidence and poor survival worldwide. We examined population-based PC incidence and survival trends in the Spanish region of Murcia during 1983-2018. METHODS: Population-based registry data were obtained. All primary invasive PC cases from 1983-2018 were included and classified as pancreatic neuroendocrine neoplasm (pNENs), non-pNENs and non-histologically-confirmed tumors. Age-specific and age-standardized incidence rates per 100,000 person-years (py) were calculated. Annual percentage changes (APCs) were estimated via joinpoint regression. Age-standardized net survival was calculated using the Pohar-Perme method. All results were stratified by sex, age, histological group and period. RESULTS: In total, 3819 patients were diagnosed. The incidence rates in men increased from 11.2/100,000 py (1983-1988) to 21.8/100,000 py (2013-2018), and those in women increased from 7.2 to 15.2/100,000 py. The APC was more pronounced in women aged 15-44 years (APC =+ 5.2%, 95% CI = 1.5, 9.0) than in men (APC =+ 0.5, 95% CI=-1.5, 2.5). Among all confirmed cases, 93.3% were non-pNENs (APC = 5.4%, 95% CI = 4.9, 6.2), and 6.7% were pNENs (APC = 8.3%, 95% CI = 6.3, 13.6). Five-year survival rates were 5.1% (95% CI = 3.3, 7.0) in the 1990s and 11.4% (95% CI = 2.7, 13.1) in the 2010s (non-pNEN patients=7.4%, pNEN patients=57.5%). CONCLUSIONS: PC incidence increased in the Spanish region of Murcia, particularly among younger women and pNEN patients. Survival improved, doubling from the 1990s to the 2010s. These findings highlight the need to develop preventive strategies targeting high-risk populations, especially young women, while improving early PC diagnosis to continue increasing PC survival rates.