Pancreatic cancer: a growing burden
Menée dans 195 pays, cette étude analyse, sur la période 1990-2017, les disparités géographiques dans l'évolution de l'incidence du cancer du pancréas, des années de vies perdues ajustées sur l'incapacité et de la mortalité en fonction des différents facteurs de risque
Pancreatic cancer, once considered a rare cancer, is a growing cause of cancer mortality worldwide. The global burden of pancreatic cancer is clearly shown by the GBD 2017 Pancreatic Cancer Collaborators: the worldwide annual incidence increased by 2·3 times from 1990 to 2017, from 196 000 (95% uncertainty interval 193 000–200 000) cases in 1990 to 441 000 (433 000–449 000) cases in 2017. Much of this increase is due to population ageing. Age is the strongest risk factor for pancreatic cancer, with death rates increasing throughout the lifespan from less than five per 100 000 person-years in the fourth decade of life to more than 60 per 100 000 person-years at the start of the eighth decade. Thus, as lifespan increases worldwide, the overall burden of pancreatic cancer will also increase. In 2012, 8% of the global population was older than age 65 years. Just 3 years later, this proportion increased to 8·5%, and by 2050 it is expected to be 16·7%. The greatest increase in the proportion of the population aged older than 65 years will be in Asia, Australia, Europe, and many regions in Latin America.As shown by the GBD Collaborators, the current age-standardised death rates of pancreatic cancer are highest in western Europe, high-income North America, high-income Asia Pacific, and Southern Latin America. Thus, it must be noted that regions with the greatest projected growth in the number of individuals aged older than 65 years are the same regions with the highest rates of pancreatic cancer when adjusting for age. As such, the recent increases in the number of pancreatic cancer cases will only continue.