Disease burden analysis of pancreatic cancer globally and in China from 1990 to 2021 and future trend projection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

REN Jiadong ¹ , HONG Yun ² , LIU Bin ¹ , MAO Yingying ¹ ,  YE Ding ¹

1. School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053. P. R. China;
2. The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, P. R. China;

Corresponding?author：

YE Ding, Email: yeding@zcmu.edu.cn

Keywords：

pancreatic cancer; disease burden; temporal trend

DOI：

10.7507/1007-9424.202503061

Video：

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Objective To systematically analyze the temporal trends of pancreatic cancer burden in globally and China from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) database and predict disease burden changes over the next 15 years. Methods The data of the incidence, death, disability-adjusted life years (DALYs) and age-standardized rate data of pancreatic cancer in GBD 2021 were extracted to analyze the epidemic status. Joinpoint regression models were employed to calculate average annual percentage changes (AAPC) and identify trend transitions. An auto-regressive integrated moving average (ARIMA) model was utilized to predict disease burden from 2022 to 2036. Results In 2021, the global age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for pancreatic cancer were 5.96 (per 100 000), 5.95 (per 100 000), and 130.33 (per 100 000). Corresponding rates in China were 5.64 (per 100 000), 5.72 (per 100 000), and 137.23 (per 100 000). From 1990 to 2021, the average annual growth rate of ASIR (AAPC=0.72%), ASMR (AAPC=0.56%) and ASDR (AAPC=0.36%) were significantly higher than the global rate (ASIR: AAPC=0.27%; ASMR: AAPC=0.16%; ASDR: AAPC=0.02%). Age-specific analysis showed that the crude incidence, mortality, and DALYs rates for the population aged ≥60 years old in China (AAPC: 0.37%–1.55%) were all increasing at a higher rate than the same age group globally (AAPC: –0.02%–0.77%). Sex differences were significant, with greater disease burden in men than in women. ARIMA model predicted that Chinese and global ASIR and ASMR will continue to rise by 2036, with persistently steeper increases in males than females. Conclusion The disease burden of pancreatic cancer in China is growing faster than that of the world, so early screening and prevention of pancreatic cancer should be strengthened.

Citation： REN Jiadong, HONG Yun, LIU Bin, MAO Yingying, YE Ding. Disease burden analysis of pancreatic cancer globally and in China from 1990 to 2021 and future trend projection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(6): 722-730. doi: 10.7507/1007-9424.202503061 Copy

1.	易麗夏, 方涵露, 李婧怡, 等. 2022年全球和中國胰腺癌發病及死亡分析. 海軍軍醫大學學報, 2024, 45(12): 1470-1477.
2.	Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2022.
3.	Wang X, Xiu R, Gong L, et al. Unraveling the global burden of inflammatory bowel disease (1990-2019): a Joinpoint regression analysis of divergent trends in 10-24 and 50-69 age cohorts. Autoimmun Rev, 2024, 23(6): 103586. doi: 10.1016/j.autrev.2024.103586.
4.	Jian Y, Zhu D, Zhou D, et al. ARIMA model for predicting chronic kidney disease and estimating its economic burden in China. BMC Public Health, 2022, 22(1): 2456. doi: 10.1186/s12889-022-14959-z.
5.	楊青龍. 全球與中國2型糖尿病疾病負擔的變化模式及預測研究. 成都: 成都醫學院, 2024.
6.	Cai J, Chen H, Lu M, et al. Advances in the epidemiology of pancreatic cancer: trends, risk factors, screening, and prognosis. Cancer Lett, 2021, 520: 1-11.
7.	時保國, 吳少龍. “看病難”的空間分析: 嵌入分層理論視角的中國三甲醫院地理分布. 甘肅行政學院學報, 2019(5): 94-103, 128.
8.	Sun D, Li H, Cao M, et al. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
9.	GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 1989-2056.
10.	Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol, 2016, 22(44): 9694-9705.
11.	McGuigan A, Kelly P, Turkington RC, et al. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol, 2018, 24(43): 4846-4861.
12.	Yang J, Xu R, Wang C, et al. Early screening and diagnosis strategies of pancreatic cancer: a comprehensive review. Cancer Commun (Lond), 2021, 41(12): 1257-1274.
13.	Dbouk M, Katona BW, Brand RE, et al. The multicenter cancer of pancreas screening study: impact on stage and survival. J Clin Oncol, 2022, 40(28): 3257-3266.
14.	Lee SY, Sissoko M, Hartshorn KL. Update on the management of pancreatic cancer in older adults. Curr Oncol Rep, 2016, 18(10): 60. doi: 10.1007/s11912-016-0547-4.
15.	Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
16.	Zhao H, Zhang Y, Liu H, et al. Age-period-cohort analysis of global, regional, and national pancreatic cancer incidence, mortality, and disability-adjusted life years, 1990-2019. BMC Cancer, 2024, 24(1): 1063. doi: 10.1186/s12885-024-12835-0.
17.	Amri F, Koulali H, Jabi R, et al. Pancreatic cancer: experience from an emerging country in North Africa. J Cancer Res Clin Oncol, 2023, 149(15): 14297-14302.
18.	唐鈞. 世界和中國的人口老齡化及其原因. 社會政策研究, 2022(3): 3-18.
19.	糜躍萍, 胡迪, 蔡波, 等. 1990–2019年江蘇省胰腺癌疾病負擔和危險因素分析. 疾病監測, 2022, 37(10): 1376-1382.
20.	周聰雅, 金龍, 張蘇, 等. 糖脂代謝與胰腺癌患者預后相關性分析. 陜西醫學雜志, 2023, 52(9): 1218-1220.
21.	劉永鵬, 張晶晶, 任艷, 等. 1990–2019年中國胰腺癌疾病負擔變化趨勢研究. 現代預防醫學, 2022, 49(17): 3079-3085.
22.	Yuan C, Kim J, Wang QL, et al. The age-dependent association of risk factors with pancreatic cancer. Ann Oncol, 2022, 33(7): 693-701.
23.	王婷, 秦毅, 徐曉武, 等. 2024年胰腺癌研究及診療新進展. 中國癌癥雜志, 2025, 35(1): 1-11.
24.	閆明玥, 湛先保, 彭小波. 胰腺癌患者的全程管理. 現代腫瘤醫學, 2024, 32(23): 4555-4561.
25.	韓家偉. 胰腺癌新輔助/轉化治療后影響預后臨床因素的篩選及預后模型的建立和驗證. 上海: 中國人民解放軍海軍軍醫大學, 2023.
26.	王馨慧, 劉小英, 付文勝. 胰腺癌的中醫藥治療研究進展. 中國中西醫結合消化雜志, 2022, 30(4): 303-307.
27.	Gram IT, Park SY, Wilkens LR, et al. Smoking and pancreatic cancer: a sex-specific analysis in the multiethnic cohort study. Cancer Causes Control, 2023, 34(1): 89-100.
28.	Zhao Z, Liu W. Pancreatic cancer: a review of risk factors, diagnosis, and treatment. Technol Cancer Res Treat, 2020, 19: 1533033820962117.

1. 易麗夏, 方涵露, 李婧怡, 等. 2022年全球和中國胰腺癌發病及死亡分析. 海軍軍醫大學學報, 2024, 45(12): 1470-1477.
2. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2021 (GBD 2021) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2022.
3. Wang X, Xiu R, Gong L, et al. Unraveling the global burden of inflammatory bowel disease (1990-2019): a Joinpoint regression analysis of divergent trends in 10-24 and 50-69 age cohorts. Autoimmun Rev, 2024, 23(6): 103586. doi: 10.1016/j.autrev.2024.103586.
4. Jian Y, Zhu D, Zhou D, et al. ARIMA model for predicting chronic kidney disease and estimating its economic burden in China. BMC Public Health, 2022, 22(1): 2456. doi: 10.1186/s12889-022-14959-z.
5. 楊青龍. 全球與中國2型糖尿病疾病負擔的變化模式及預測研究. 成都: 成都醫學院, 2024.
6. Cai J, Chen H, Lu M, et al. Advances in the epidemiology of pancreatic cancer: trends, risk factors, screening, and prognosis. Cancer Lett, 2021, 520: 1-11.
7. 時保國, 吳少龍. “看病難”的空間分析: 嵌入分層理論視角的中國三甲醫院地理分布. 甘肅行政學院學報, 2019(5): 94-103, 128.
8. Sun D, Li H, Cao M, et al. Cancer burden in China: trends, risk factors and prevention. Cancer Biol Med, 2020, 17(4): 879-895.
9. GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 1989-2056.
10. Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol, 2016, 22(44): 9694-9705.
11. McGuigan A, Kelly P, Turkington RC, et al. Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol, 2018, 24(43): 4846-4861.
12. Yang J, Xu R, Wang C, et al. Early screening and diagnosis strategies of pancreatic cancer: a comprehensive review. Cancer Commun (Lond), 2021, 41(12): 1257-1274.
13. Dbouk M, Katona BW, Brand RE, et al. The multicenter cancer of pancreas screening study: impact on stage and survival. J Clin Oncol, 2022, 40(28): 3257-3266.
14. Lee SY, Sissoko M, Hartshorn KL. Update on the management of pancreatic cancer in older adults. Curr Oncol Rep, 2016, 18(10): 60. doi: 10.1007/s11912-016-0547-4.
15. Lin QJ, Yang F, Jin C, et al. Current status and progress of pancreatic cancer in China. World J Gastroenterol, 2015, 21(26): 7988-8003.
16. Zhao H, Zhang Y, Liu H, et al. Age-period-cohort analysis of global, regional, and national pancreatic cancer incidence, mortality, and disability-adjusted life years, 1990-2019. BMC Cancer, 2024, 24(1): 1063. doi: 10.1186/s12885-024-12835-0.
17. Amri F, Koulali H, Jabi R, et al. Pancreatic cancer: experience from an emerging country in North Africa. J Cancer Res Clin Oncol, 2023, 149(15): 14297-14302.
18. 唐鈞. 世界和中國的人口老齡化及其原因. 社會政策研究, 2022(3): 3-18.
19. 糜躍萍, 胡迪, 蔡波, 等. 1990–2019年江蘇省胰腺癌疾病負擔和危險因素分析. 疾病監測, 2022, 37(10): 1376-1382.
20. 周聰雅, 金龍, 張蘇, 等. 糖脂代謝與胰腺癌患者預后相關性分析. 陜西醫學雜志, 2023, 52(9): 1218-1220.
21. 劉永鵬, 張晶晶, 任艷, 等. 1990–2019年中國胰腺癌疾病負擔變化趨勢研究. 現代預防醫學, 2022, 49(17): 3079-3085.
22. Yuan C, Kim J, Wang QL, et al. The age-dependent association of risk factors with pancreatic cancer. Ann Oncol, 2022, 33(7): 693-701.
23. 王婷, 秦毅, 徐曉武, 等. 2024年胰腺癌研究及診療新進展. 中國癌癥雜志, 2025, 35(1): 1-11.
24. 閆明玥, 湛先保, 彭小波. 胰腺癌患者的全程管理. 現代腫瘤醫學, 2024, 32(23): 4555-4561.
25. 韓家偉. 胰腺癌新輔助/轉化治療后影響預后臨床因素的篩選及預后模型的建立和驗證. 上海: 中國人民解放軍海軍軍醫大學, 2023.
26. 王馨慧, 劉小英, 付文勝. 胰腺癌的中醫藥治療研究進展. 中國中西醫結合消化雜志, 2022, 30(4): 303-307.
27. Gram IT, Park SY, Wilkens LR, et al. Smoking and pancreatic cancer: a sex-specific analysis in the multiethnic cohort study. Cancer Causes Control, 2023, 34(1): 89-100.
28. Zhao Z, Liu W. Pancreatic cancer: a review of risk factors, diagnosis, and treatment. Technol Cancer Res Treat, 2020, 19: 1533033820962117.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Disease burden analysis of pancreatic cancer globally and in China from 1990 to 2021 and future trend projection

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