ABSTRACT: The Trend of Pancreatic Cancer in the United States: 1977-2001

Prasun K. Jalal, MD; Baaz Michiev, MD; Simmy Bank, MD

Long Island Jewish Medical Center - Albert Einstein College of Medicine
New York

Purpose

Pancreatic cancer is the fourth leading cause of cancer deaths for both sexes in the Unites States. Despite the poor survival and delayed diagnosis, epidemiological data is lacking to delineate the recent trend. The aim of our study was to examine the temporal trends in the incidence and mortality of pancreatic cancer in the United States.

Methods

Data was collected and analyzed from the Surveillance, Epidemiology, and End Results (SEER) database to determine the age-adjusted incidence of microscopically confirmed pancreatic cancer from 1977 to 2001. US mortality data, maintained by National Center for Health Statistics (NCHS), was also analyzed to generate age-adjusted mortality rates over the same period. The age-adjusted incidence rates were calculated by 5-yr intervals. Sex- and ethnicity-specific (white, black and other) incidence rates and 95% confidence intervals were also calculated. Age-specific incidence rates were determined for all patients and each of 3 groups of ethnicity.

Results

The overall incidence of pancreatic cancer for the period 1977 to 2001 was 11.5 per 100,000 (95% CI, 11.4 to 11.6). 75% of all pancreatic cancers had microscopic confirmation; of them 82% had positive histology and 18% were diagnosed by cytology. The incidence of microscopically confirmed pancreatic cancer for the period 1977 to 1981 was 8.3 per 100,000 (95 percent CI, 8.1 to 8.5) and was 8.6 per 100,000 (95 percent CI, 8.4 to 8.8) for the period 1997 to 2001. The incidence rises with age and peaks in the 70-79 yr age group to 49 per 100,000 (95 percent CI, 47.4 to 50.6) for the period 1997 to 2001. Black men had the highest incidence with 14.2 per 100,000 (95 percent CI, 13 to 15.4) for the same period. 82% of pancreatic cancer patients had regional or distal metastasis at the time of diagnosis. The overall mortality rates remained unchanged; 10.7 per 100,000 population (95 percent CI, 10.7 to 10.8) for the period 1977 to 1981 and 10.5 per 100,000 population (95 percent CI, 10.5 to 10.6) for the period 1997 to 2001. The mortality rate for black men was highest with 16 per 100,000 (95 percent CI, 15.7 to 16.4) for the period 1997 to 2001.

Conclusions

The trends in incidence and mortality of pancreatic cancer for the period of 1977 to 2001 have shown little change despite improved diagnostic and therapeutic options. The incidence increases with age. Black men had the highest age-adjusted incidence and mortality rates from pancreatic cancer.