A large study spanning 195 countries found that colorectal and pancreatic cancer rates have increased by 10% between 1990 and 2017, according to a study published in The Lancet Gastroenterology & Hepatology.
The Global Burden of Disease Study, funded by the Bill & Melinda Gates Foundation, used vital registration, vital registration sample, and cancer registry data to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. Researchers used the comparative risk assessment framework to estimate the proportion of deaths attributable to the following risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body mass index.
In 2017, there were 448,000 incident cases of pancreatic cancer worldwide, 232,000 of which occurred in men. This represented a 130% increase from the 195,000 incident cases of pancreatic cancer recorded in 1990. The age-standardized incidence rate was 5.0 per 100,000 person-years in 1990 and increased to 5.7 per 100,000 person-years in 2017. The number of pancreatic cancer-related deaths increased by 2.3 times for both men and women from 196,000 in 1990 to 441,000 in 2017. DALYs due increased by 2.1 times from 4.4 million in 1990 to 9.1 million in 2017.
The age-standardized pancreatic cancer mortality rate was highest in the high-income super-region across all study years. In 2017, the highest age-standardized mortality rates were observed in Greenland and Uruguay; these countries also had the highest age-standardized death rates in 1990.
The numbers of incident cases and deaths peaked at age 65 to 69 years in men and 75 to 79 years in women. The authors noted that age-standardized pancreatic cancer deaths worldwide were primarily related to smoking (21.1%), high fasting plasma glucose (8·9%), and high body mass index (6.2%) in 2017, likely related to the increase in obesity and diabetes.
From 1990 to 2017, age-standardized incidence rates for colorectal cancer (CRC) increased 9.5% globally, while age-standardized mortality rates decreased by 13.5%. The researchers said this is likely due to the introduction of CRC screening programs, which can lead to earlier detection and potentially improved survival.
The study also revealed that CRC risk factors differ for men and women: alcohol use, smoking, and diets low in calcium, milk, and fiber increased the risk for males, while dietary issues alone were a top risk for women.