In a study reported in a research letter in JAMA, Gaddam et al found that the incidence of pancreatic cancer has increased in both men and women between 2000 and 2018, with a greater relative increase being observed in younger women.
Pancreatic cancer incidence rates per 100,000 population (age-adjusted to the 2000 U.S. population and adjusted for reporting delay) for 2000–2018 were obtained from the Surveillance, Epidemiology, and End Results database. Average annual percentage changes in incidence were calculated. Significance levels were P < .05 for the overall population and, to adjust for multiple comparisons, P < .025 for analyses of < 55 year and ≥ 55 year age groups and P < .0125 for analyses of 15 to 34 and 35 to 54 year age groups.
Key Findings
A total of 283,817 cases of pancreatic cancer (50% women) were reported between 2000 and 2018. In the entire population, average annual percentage changes significantly increased in women (0.78%, 95% confidence interval [CI] = 0.68%–0.88%, P < .001) and in men (0.90%, 95% CI = 0.82%–0.99%, P < .001), with no significant between-group difference (0.12%, 95% CI = 0%–0.25%, P = .06).
Among patients aged at least 55 years (251,360 cases; 51% women), average annual percentage changes significantly increased among women (0.62%, 95% CI = 0.51%–0.74%, P < .001) and men (0.92%, 95% CI = 0.82%–1.01%), with a significantly greater relative increase among men (P < .001).
Among patients aged less than 55 years (32,369 cases, 11.4% of total of total cases; 43% women), average annual percentage changes significantly increased in women (1.93%, 95% CI = 1.57%–2.28%, P < .001) and men (0.77%, 95% CI = 0.50%–1.05%, P < .001), with a significantly greater relative increase in women (P = .002).
Among patients aged 35 to 54 years (30,831 cases), average annual percentage changes increased significantly among women (1.56%, 95% CI = 1.24%–1.87%, P < .001) and men (0.65%, 95% CI = 0.38%–0.91%, P < .001), with a significantly greater relative increase among women (P = .004).
Among patients aged 15 to 34 years (1,538 cases), average annual percentage changes increased significantly among women (7.68%, 95% CI = 6.21%–9.18%, P < .001) and men (4.20%, 95% CI = 2.54%–5.90%, P < .001), with a significantly greater relative increase in women (P = .01).
The investigators stated: “This study found that pancreatic cancer incidence increased among both sexes between 2000 and 2018. However, a greater relative increase was observed among women younger than aged 55 years, especially among those aged 15 to 34 years. Even though the reason for this relative increasing trend among younger women is unclear, it may imply a sex-based disproportional exposure to known or unknown risk factors. The observed trend can offer clues to researchers to gain better insight into pathogenesis of pancreatic cancer.”
Srinivas Gaddam, MD, MPH, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, is the corresponding author for the JAMA article.
Disclosure: The study was supported a grant from the Widjaja Family Fund for Pancreatic Cancer Research. For full disclosures of the study authors, visit jamanetwork.com.
