Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016

doi:10.19401/j.cnki.1007-3639.2022.02.001

Abstract

Abstract:

Background and purpose: The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on pancreatic cancer occurrence and trends in Shanghai. Pancreatic cancer, which has increased the disease burden to the society and patients with their families due to the lack of early symptoms and poor prognosis, remains one of the most common gastrointestinal tumors. This study aimed to analyze the current epidemic status of pancreatic cancer in Shanghai in 2016 and the prevalence trend from 2002 to 2016, and to provide a basis for the prevention and treatment of pancreatic cancer and further research. Methods: Data on pancreatic cancer in Shanghai from 2002 to 2016 were obtained through Shanghai Municipal Center for Disease Control and Prevention Population-based Cancer Registry and Vital Statistics System. In all cases of pancreatic cancer, morphological verification (MV) and non-morphological verification were taken as the highest basis for diagnosis. The number of cases and deaths, crude rates, composition ratios, age-specific rates and cumulative rates were counted according to the year of incidence or death, sex and age groups. Segi’s 1960 world standard population was used to calculate age-standardized rates of incidence and mortality and corresponding truncated age-standardized rate (35-64 years) of pancreatic cancer. Z-test and Cochran test were used to compare the differences of age-specific rates and age-standardized rates among different subgroups, respectively. Temporal trend analyses were conducted by Joinpoint software, and annual percent changes (APCs) were used to describe the trends. Results: In 2016, the MV proportion of new cases of pancreatic cancer in Shanghai was 41.25%, the proportion of cases with death certification only was 0.68%, and the ratio of death to incidence was 0.87. The number of new cases and deaths of pancreatic cancer in Shanghai in 2016 was 2 943 and 2 554, respectively. The crude incidence of pancreatic cancer in Shanghai in 2016 was 20.32/100 000, with an age-standardized incidence of 7.28/100 000. New cases of pancreatic cancer accounted for 3.95% of all malignant tumors, ranking 7 ^th in the incidence spectrum of malignant tumors. The truncated age-standardized incidence (35-64 years) was 9.53/100 000, and the cumulative incidences for 0-64 years, 0-74 years and 0-84 years were 0.34%, 0.81% and 1.76%, respectively. The crude mortality of pancreatic cancer in Shanghai in 2016 was 17.64/100 000, with an age-standardized mortality of 6.01/100 000. Deaths of pancreatic cancer accounted for 6.90% of all malignant tumor deaths, ranking 5 ^th in the mortality spectrum of malignant tumors. The truncated age-standardized mortality (35-64 years) was 7.16/100 000, and the cumulative mortalities for 0-64 years, 0-74 years and 0-84 years were 0.26%, 0.64% and 1.57%, respectively. The age-standardized incidence and mortality were significantly higher in men than in women. The age-specific new cases, deaths and rates of pancreatic cancer in Shanghai in 2016 showed an upward trend with increasing age, and the age-specific incidence and mortality peaked at 108.66/100 000 and 106.97/100 000, respectively, among people aged 85 and over. From 2002 to 2016, both the number of new cases and deaths of pancreatic cancer in Shanghai showed a gradual increase trend, of which the number of new cases of pancreatic cancer increased from 1 510 in 2002 to 2 943 in 2016, and the number of deaths increased from 1 458 in 2002 to 2 554 in 2016. Joinpoint analyses showed a significant upward trend in the standardized incidence of pancreatic cancer in Shanghai from 2002 to 2016, with an average annual increase of 0.89% (APC=0.89, t=5.69, P<0.001), while the increase in standardized mortality was not statistically significant. Conclusions: The incidence of pancreatic cancer in Shanghai from 2002 to 2016 showed an upward trend, while the mortality showed a fluctuating trend. Since there is no effective screening tool, a population-based study on the current epidemic status and trend of pancreatic cancer is of great significance for pancreatic cancer prevention and treatment.

Key words: Pancreatic cancer, Incidence, Mortality, Trend analysis, Shanghai

CLC Number:

R735.9

WU Mengyin, WU Chunxiao, PANG Yi, WANG Chunfang, GU Kai, GONG Yangming, BAO Pingping, SHI Liang, DOU Jianming, XIANG Yongmei, SHI Yan. Incidence and mortality of pancreatic cancer in Shanghai 2016 and epidemic trend analysis from 2002 to 2016[J]. China Oncology, 2022, 32(2): 97-105.

Figures/Tables 7

Tab. 1

Fig. 1

Fig. 2

Fig. 3

Tab. 2

Trend of age-specific incidence and mortality rates of pancreatic cancer in Shanghai, 2002-2016"

Index	Age group	Age-specific rat/10^-5			Age-specific rate 2007-2011/2002-2006			Age-specific rate 2012-2016/2007-2011
Index	Age group	2002—2006	2007—2011	2012—2016	Rate	Z value	P value	Rate	Z value	P value
Incidence	20-	0.14	0.24	0.18	1.72	1.152	0.249	0.75	0.608	0.543
	25-	0.23	0.22	0.26	0.96	0.104	0.917	1.19	0.434	0.664
	30-	0.29	0.40	0.54	1.35	0.824	0.410	1.37	1.088	0.276
	35-	1.08	1.02	1.21	0.95	0.262	0.793	1.18	0.833	0.405
	40-	2.47	2.09	2.02	0.85	1.355	0.175	0.96	0.252	0.801
	45-	4.67	4.45	4.37	0.95	0.595	0.552	0.98	0.218	0.827
	50-	7.67	9.75	10.79	1.27	4.179	<0.001	1.11	1.912	0.056
	55-	14.09	15.88	18.22	1.13	2.356	0.018	1.15	3.401	0.001
	60-	25.40	25.94	25.76	1.02	0.456	0.648	0.99	0.191	0.849
	65-	38.34	39.64	37.94	1.03	0.794	0.427	0.96	1.147	0.251
	70-	56.57	60.66	56.43	1.07	2.011	0.044	0.93	2.059	0.040
	75-	75.22	83.06	85.09	1.10	2.995	0.003	1.02	0.778	0.436
	80-	92.62	98.98	100.34	1.07	1.715	0.086	1.01	0.415	0.678
	≥85	87.07	111.03	107.71	1.28	4.977	<0.001	0.97	0.805	0.421
Mortality	20-	0.04	0.06	0.06	1.50	0.450	0.653	0.99	0.007	0.994
	25-	0.07	0.13	0.04	1.86	0.945	0.345	0.31	1.565	0.118
	30-	0.29	0.26	0.18	0.90	0.249	0.803	0.66	0.943	0.346
	35-	0.79	0.65	0.72	0.82	0.809	0.419	1.10	0.374	0.708
	40-	1.65	1.65	1.43	1.00	0.016	0.987	0.87	0.865	0.387
	45-	3.46	3.72	3.18	1.08	0.828	0.407	0.86	1.524	0.128
	50-	6.00	7.76	8.11	1.29	3.967	0.000	1.04	0.726	0.468
	55-	10.42	13.07	14.34	1.26	3.975	0.000	1.10	2.048	0.041
	60-	19.60	22.04	20.74	1.12	2.258	0.024	0.94	1.459	0.145
	65-	32.16	36.08	32.47	1.12	2.561	0.010	0.90	2.585	0.010
	70-	48.58	54.81	50.00	1.13	3.264	0.001	0.91	2.474	0.013
	75-	68.42	77.13	79.31	1.13	3.470	0.001	1.03	0.867	0.386
	80-	87.24	98.12	97.75	1.12	2.992	0.003	1.00	0.116	0.908
	≥85	89.58	111.41	110.47	1.24	4.494	<0.001	0.99	0.226	0.821

Tab. 2

Fig. 4

Tab. 3

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Index	Incidence of pancreatic cancer			Death of pancreatic cancer
Index	Total	Male	Female	Total	Male	Female
Case n	2 943	1 594	1 349	2 554	1 364	1 190
Constituent ratio/%	3.95	4.10	3.79	6.90	6.00	8.34
Crude rate/10^-5	20.32	22.19	18.49	17.64	18.99	16.31
ASR world/10^-5*	7.28	8.56	6.03	6.01	7.05	4.98
Truncated rate/10^-5
35-64 years	9.53	12.15	6.90	7.16	9.00	5.32
Cumulative rate/%
0-64 years	0.34	0.43	0.25	0.26	0.32	0.19
0-74 years	0.81	0.97	0.65	0.64	0.78	0.51
0-84 years	1.76	1.96	1.57	1.57	1.77	1.38

Index	2002-2006		2007-2011		2012-2016
Index	Case n	Constituent ratio/%	Case n	Constituent ratio/%	Case n	Constituent ratio/%
Morphological verification	1 756	20.70	2 862	25.55	5 102	37.68
Classification (ICD-10)
Head of pancreas	2 982	35.15	2 832	25.28	2 115	15.62
Body of pancreas	239	2.82	241	2.15	195	1.44
Tail of pancreas	314	3.70	345	3.08	317	2.34
Pancreatic duct	7	0.08	8	0.07	16	0.12
Endocrine pancreas	134	1.58	120	1.07	123	0.91
Other parts of pancreas	27	0.32	52	0.46	95	0.70
Overlapping lesion of pancreas	222	2.62	323	2.88	344	2.54
Pancreas, unspecified	4 558	53.73	7 281	65.00	10 337	76.33
Histological type
Ductal carcinoma	231	2.72	629	5.62	1 420	10.49
Adenocarcinoma	922	10.86	1 152	10.28	1 466	10.83
Other types	254	2.99	229	2.04	405	2.99
Neoplasm, malignant	7 076	83.41	9 192	82.06	10 251	75.70
Neoplasm staging
Ⅰ	130	1.53	137	1.22	284	2.10
Ⅱ	279	3.29	421	3.76	729	5.38
Ⅲ	481	5.67	596	5.32	734	5.42
Ⅳ	1 740	20.51	2 699	24.09	3 128	23.10
Unknown	5 853	69.00	7 349	65.60	8 667	64.00