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. 2023 Sep 18;23(1):876.
doi: 10.1186/s12885-023-11369-1.

Time trend of pancreatic cancer mortality in the Western Pacific Region: age-period-cohort analysis from 1990 to 2019 and forecasting for 2044

Wenkai Jiang #  1 , Caifei Xiang #  1 , Yan Du  1 , Xiao Li  1 , Xin Li  2 , Wence Zhou  3   4
Affiliations

Time trend of pancreatic cancer mortality in the Western Pacific Region: age-period-cohort analysis from 1990 to 2019 and forecasting for 2044

Wenkai Jiang et al. BMC Cancer. .

Abstract

Background: Pancreatic cancer poses a serious medical problem worldwide. Countries in the Western Pacific Region are facing public health challenges from cancer. This study assesses the time trends of pancreatic cancer mortality in the Western Pacific Region from 1990 to 2019 and predicts its trend to 2044.

Methods: Mortality data were obtained from the Global Health Data Exchange. We used an age-period-cohort model to estimate age, period and birth cohort effects on pancreatic cancer mortality from 1990 to 2019 by calculating net drift, local drift, age-specific rate, period rate ratio, and cohort rate ratio. We also predict pancreatic cancer mortality to 2044 in Western Pacific countries.

Results: Overall, there were 178,276 (95% uncertain interval: 157,771 to 198,636) pancreatic cancer deaths in the Western Pacific Region in 2019, accounting for 33.6% of all deaths due to pancreatic cancer worldwide. There were significant increases in pancreatic cancer disability-adjusted life years between 1990 and 2019 in the Western Pacific Region, mainly due to population growth and aging. Pancreatic cancer mortality increased with age. The period effect showed an increasing trend of mortality for both sexes over the study period. Compared to the reference period (2000 to 2004), the rate ratio was elevated in both males and females in the period of 2015 to 2019. There was an overall increasing rate ratio from early birth cohorts to recent cohorts. Deaths may continue to increase in the next 25 years in the ten countries, while most countries have seen their age-standardized rate forecasts fall.

Conclusion: The mortality of pancreatic cancer is still high in the Western Pacific Region. Countries/territories should focus on pancreatic cancer prevention and early cancer screening in high-risk populations. Specific public health methods and policies aimed at reducing risk factors for pancreatic cancer are also needed.

Keywords: Age-period-cohort model; Forecasting; Mortality; Pancreatic cancer; Western Pacific Region.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Time trends of pancreatic cancer mortality in the Western Pacific Region, 1990 to 2019. A Counts and age-standardized rates of pancreatic cancer mortality by sex, 1990 to 2019. B Age-standardized death rate for pancreatic cancer attributable to smoking, high fasting plasma glucose and high body mass index by sex, 1990 to 2019
Fig. 2
Fig. 2
Age-specific counts and rates of deaths of pancreatic cancer by sex in Western Pacific Region, 2019
Fig. 3
Fig. 3
Classification analysis of Western Pacific countries by estimated annual percentage changes (1990 to 2019) and age-standardized death rate (2019) of pancreatic cancer mortality. EAPC: estimated annual percentage change
Fig. 4
Fig. 4
Decomposition analysis of age-related DALYs of pancreatic cancer in the Western Pacific Region, between 1990 and 2019. A Decomposition analysis by sex in the Western Pacific Region. B Decomposition analysis of five Western Pacific countries. DALYs: disability adjusted life years
Fig. 5
Fig. 5
Age distribution of pancreatic cancer deaths and local drifts of pancreatic cancer mortality by SDI and sex, 1990 to 2019. Temporal change in the relative proportion of pancreatic cancer deaths across age groups (15 to 49 years, 50 to 69 years, 70 + years) in (A) both sexes, B males and (C) females, 1990 to 2019. Local drifts of pancreatic cancer mortality (from age-period-cohort models) for 16 age groups in (D) both sexes, E males and (F) females, 1990 to 2019
Fig. 6
Fig. 6
Age, period and cohort effects on pancreatic cancer mortality by sex. A Age effects are shown by the fitted longitudinal age curves of mortality (per 100,000). B Period effects are shown by the mortality rate ratio. C Cohort effects are shown by the mortality rate ratio
Fig. 7
Fig. 7
Age-standardized death rates of pancreatic cancer in 1990 and 2019 and predicted rates in 2044 in ten Western Pacific countries
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