CoChat
Sign Up
Cited by 308Pancreatic and Hepatic Oncology ResearchGlobal Cancer Incidence and ScreeningPancreatitis Pathology and Treatment

Burden of Pancreatic Cancer: From Epidemiology to Practice

Open access
Khalaf, Natalia, El-Serag, Hashem B., Abrams, Hannah R., Thrift, Aaron P.·2021·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2020.02.054PMC PMC8559554
Open this paper in CoChat — free accountOpen PDF

Abstract

Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide with 432,242 related deaths in 2018. Unlike other cancers, the incidence of pancreatic cancer continues to increase, with little improvement in survival rates. We review the epidemiologic features of pancreatic cancer, covering surveillance and early detection in high-risk persons. We summarize data on worldwide incidence and mortality and analyze the 1975-2016 data from 9 registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results study, on the overall burden of pancreatic cancer as well as age-, sex-, and race-specific incidence, survival rates and trends. It is important to increase our knowledge of the worldwide and regional epidemiologic features of and risk factors for pancreatic cancer, to identify new approaches for prevention, surveillance, and treatment.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.cgh.2020.02.054

Cites

9 of 9 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • At diagnosis, only 10-15% of pancreatic cancer patients have localised disease and are potential candidates for curative resection.

    “At diagnosis, only 10–15% of patients have localised disease and are potential candidates for curative resection [2, 3].”

    From Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer (2023) · cites this paper as [3]

    The “Prognosis for patients with pancreatic cancer” section (page not available in our copy) says that around 10% of U.S. patients are diagnosed with localized, resectable disease. This supports the central point, but the cited passage gives a U.S.-specific estimate rather than the unqualified 10–15% range in the claim. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 75

  1. [3]Raimondi S, Maisonneuve P, Lowenfels AB. Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol 2009; 6: 699– 708. 19806144
  2. [4]Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69: 7– 34. 30620402
  3. [5]Fuchs CS, Colditz GA, Stampfer MJ, A prospective study of cigarette smoking and the risk of pancreatic cancer. Arch Intern Med 1996; 156: 2255– 2260. 8885826
  4. [7]Larsson SC, Permert J, Håkansson N, Overall obesity, abdominal adiposity, diabetes and cigarette smoking in relation to the risk of pancreatic cancer in two Swedish population-based cohorts. Br J Cancer 2005; 93: 1310– 1315. 16288300 PMC2361517
  5. [8]Lynch SM, Vrieling A, Lubin JH, Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium. Am J Epidemiol 2009; 170: 403– 413. 19561064 PMC2733861
  6. [9]Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol 2016; 22: 9694– 9705. 27956793 PMC5124974
  7. [10]Mathers CD, Fat DM, Inoue M, Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ 2005; 83: 171– 177. 15798840 PMC2624200
  8. [11]Ferlay J, Partensky C, Bray F. More deaths from pancreatic cancer than breast cancer in the EU by 2017. Acta Oncol Stockh Swed 2016; 55: 1158– 1160. 27551890
  9. [13]Wong MCS, Jiang JY, Liang M, Global temporal patterns of pancreatic cancer and association with socioeconomic development. Sci Rep 2017; 7: 3165. 28600530 PMC5466634
  10. [14]Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology 2013; 144: 1252– 1261. 23622135 PMC3662544
  11. [15]Arslan AA. Anthropometric Measures, Body Mass Index, and Pancreatic Cancer: A Pooled Analysis From the Pancreatic Cancer Cohort Consortium (PanScan). Arch Intern Med 2010; 170: 791. 20458087 PMC2920035
  12. [17]Rahib L, Smith BD, Aizenberg R, Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res 2014; 74: 2913– 2921. 24840647
  13. [19]Khawja SN, Mohammed S, Silberfein EJ, Pancreatic cancer disparities in African Americans. Pancreas 2015; 44: 522– 527. 25872128
  14. [20]Ma J, Siegel R, Jemal A. Pancreatic cancer death rates by race among US men and women, 1970–2009. J Natl Cancer Inst 2013; 105: 1694– 1700. 24203988
  15. [21]Midha S, Chawla S, Garg PK. Modifiable and non-modifiable risk factors for pancreatic cancer: A review. Cancer Lett 2016; 381: 269– 277. 27461582
  16. [22]Jarosz M, Sekula W, Rychlik E. Influence of diet and tobacco smoking on pancreatic cancer incidence in poland in 1960–2008. Gastroenterol Res Pract 2012; 2012: 682156. 23319943 PMC3536043
  17. [23]Michaud DS, Giovannucci E, Willett WC, Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 2001; 286: 921– 929. 11509056
  18. [24]Patel AV, Rodriguez C, Bernstein L, Obesity, recreational physical activity, and risk of pancreatic cancer in a large U.S. Cohort. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 2005; 14: 459– 466. 15734973
  19. [25]Zhou B, Wu D, Liu H, Obesity and pancreatic cancer: An update of epidemiological evidence and molecular mechanisms. Pancreatol Off J Int Assoc Pancreatol IAP Al 8 2019. 31447281
  20. [26]Berrington de González A, Spencer EA, Bueno-de-Mesquita HB, Anthropometry, physical activity, and the risk of pancreatic cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 2006; 15: 879– 885. 16702364
  21. [27]Pericleous M, Rossi RE, Mandair D, Nutrition and pancreatic cancer. Anticancer Res 2014; 34: 9– 21. 24403441
  22. [28]Lowenfels AB, Maisonneuve P. Epidemiology and prevention of pancreatic cancer. Jpn J Clin Oncol 2004; 34: 238– 244. 15231857
  23. [29]Taunk P, Hecht E, Stolzenberg-Solomon R. Are meat and heme iron intake associated with pancreatic cancer? Results from the NIH-AARP diet and health cohort. Int J Cancer 2016; 138: 2172– 2189. 26666579 PMC4764390
  24. [30]Larsson SC, Wolk A. Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. Br J Cancer 2012; 106: 603– 607. 22240790 PMC3273353
  25. [31]Alsamarrai A, Das SLM, Windsor JA, Factors that affect risk for pancreatic disease in the general population: a systematic review and meta-analysis of prospective cohort studies. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2014; 12: 1635– 1644.e5; quiz e103. 24509242
  26. [32]Wu Q-J, Wu L, Zheng L-Q, Consumption of fruit and vegetables reduces risk of pancreatic cancer: evidence from epidemiological studies. Eur J Cancer Prev Off J Eur Cancer Prev Organ ECP 2016; 25: 196– 205. 26075658
  27. [33]Arem H, Reedy J, Sampson J, The Healthy Eating Index 2005 and risk for pancreatic cancer in the NIH-AARP study. J Natl Cancer Inst 2013; 105: 1298– 1305. 23949329 PMC3760780
  28. [34]Bosetti C, Bravi F, Turati F, Nutrient-based dietary patterns and pancreatic cancer risk. Ann Epidemiol 2013; 23: 124– 128. 23332711
  29. [35]Jiao L, Mitrou PN, Reedy J, A combined healthy lifestyle score and risk of pancreatic cancer in a large cohort study. Arch Intern Med 2009; 169: 764– 770. 19398688 PMC3498842
  30. [36]Liu S-L, Zhao Y-P, Dai M-H, Vitamin D status and the risk of pancreatic cancer: a meta-analysis. Chin Med J (Engl) 2013; 126: 3356– 3359. 24033964
  31. [37]Permuth-Wey J, Egan KM. Family history is a significant risk factor for pancreatic cancer: results from a systematic review and meta-analysis. Fam Cancer 2009; 8: 109– 117. 18763055
  32. [38]Wang W, Chen S, Brune KA, PancPRO: risk assessment for individuals with a family history of pancreatic cancer. J Clin Oncol Off J Am Soc Clin Oncol 2007; 25: 1417– 1422. PMC2267288 17416862
  33. [39]Wang L, Brune KA, Visvanathan K, Elevated cancer mortality in the relatives of patients with pancreatic cancer. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 2009; 18: 2829– 2834. PMC3190638 19843679
  34. [40]Solomon S, Das S, Brand R, Inherited pancreatic cancer syndromes. Cancer J Sudbury Mass 2012; 18: 485– 491. PMC3565835 23187834
  35. [41]Anand N, Sampath K, Wu BU. Cyst features and risk of malignancy in intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2013; 11: 913– 921; quiz e59–60. 23416279
  36. [42]Singhi AD, Koay EJ, Chari ST, Early Detection of Pancreatic Cancer: Opportunities and Challenges. Gastroenterology 2019; 156: 2024– 2040. 30721664 PMC6486851
  37. [43]Huxley R, Ansary-Moghaddam A, Berrington de González A, Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer 2005; 92: 2076– 2083. 15886696 PMC2361795
  38. [44]Ben Q, Xu M, Ning X, Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Cancer Oxf Engl 1990 2011; 47: 1928– 1937. 21458985
  39. [45]Malka D, Hammel P, Maire F, Risk of pancreatic adenocarcinoma in chronic pancreatitis. Gut 2002; 51: 849– 852. 12427788 PMC1773474
  40. [46]El-Serag HB, Engels EA, Landgren O, Risk of hepatobiliary and pancreatic cancers after hepatitis C virus infection: A population-based study of U.S. veterans. Hepatol Baltim Md 2009; 49: 116– 123. PMC2719902 19085911
  41. [47]Velema JP, Walker AM, Gold EB. Alcohol and pancreatic cancer. Insufficient epidemiologic evidence for a causal relationship. Epidemiol Rev 1986; 8: 28– 41. 3533583
  42. [48]Ye W, Lagergren J, Weiderpass E, Alcohol abuse and the risk of pancreatic cancer. Gut 2002; 51: 236– 239. 12117886 PMC1773298
  43. [49]Khalaf N, Yuan C, Hamada T, Regular Use of Aspirin or Non-Aspirin Nonsteroidal Anti-Inflammatory Drugs Is Not Associated With Risk of Incident Pancreatic Cancer in Two Large Cohort Studies. Gastroenterology 2018; 154: 1380– 1390.e5. 29229401 PMC5880716
  44. [50]Lee HS, Lee SH, Lee HJ, Statin Use and Its Impact on Survival in Pancreatic Cancer Patients. Medicine (Baltimore) 2016; 95. PMC4902509 27175667
  45. [51]Jian-Yu E null, Graber JM, Lu S-E, Effect of Metformin and Statin Use on Survival in Pancreatic Cancer Patients: a Systematic Literature Review and Meta-analysis. Curr Med Chem 2018; 25: 2595– 2607. 28403788 PMC5638687
  46. [52]Hamada T, Khalaf N, Yuan C, Prediagnosis Use of Statins Associates With Increased Survival Times of Patients With Pancreatic Cancer. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2018; 16: 1300– 1306.e3. PMC6056316 29474971
  47. [53]Hamada T, Khalaf N, Yuan C, Statin use and pancreatic cancer risk in two prospective cohort studies. J Gastroenterol 2018; 53: 959– 966. 29362938 PMC7609961
  48. [54]Jiao L, Chen L, White DL, Low-fat Dietary Pattern and Pancreatic Cancer Risk in the Women’s Health Initiative Dietary Modification Randomized Controlled Trial. J Natl Cancer Inst 2018; 110. PMC6059156 28922784
  49. [55]Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19–9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: An evidence based appraisal. J Gastrointest Oncol 2012; 3: 105– 119. 22811878 PMC3397644
  50. [58]Canto MI, Almario JA, Schulick RD, Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance. Gastroenterology 2018; 155: 740– 751.e2. 29803839 PMC6120797
  51. [60]Syngal S, Brand RE, Church JM, ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol 2015; 110: 223– 262; quiz 263. 25645574 PMC4695986
  52. [61]Elta GH, Enestvedt BK, Sauer BG, ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol 2018; 113: 464– 479. 29485131
  53. [62]Kosmahl M, Pauser U, Peters K, Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Arch Int J Pathol 2004; 445: 168– 178. 15185076
  54. [64]Tanaka M, Fernández-Del Castillo C, Kamisawa T, Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatol Off J Int Assoc Pancreatol IAP Al 2017; 17: 738– 753. 28735806
  55. [65]Marchegiani G, Fernández-del Castillo C. Is it safe to follow side branch IPMNs? Adv Surg 2014; 48: 13– 25. 25293604
  56. [66]Scheiman JM, Hwang JH, Moayyedi P. American gastroenterological association technical review on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015; 148: 824– 848.e22. 25805376
  57. [67]Xu M-M, Yin S, Siddiqui AA, Comparison of the diagnostic accuracy of three current guidelines for the evaluation of asymptomatic pancreatic cystic neoplasms. Medicine (Baltimore) 2017; 96: e7900. 28858107 PMC5585501
  58. [68]Chari ST, Leibson CL, Rabe KG, Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology 2005; 129: 504– 511. 16083707 PMC2377196
  59. [69]Chari ST, Leibson CL, Rabe KG, Pancreatic cancer-associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer. Gastroenterology 2008; 134: 95– 101. 18061176 PMC2271041
  60. [71]Aggarwal G, Rabe KG, Petersen GM, New-onset diabetes in pancreatic cancer: a study in the primary care setting. Pancreatol Off J Int Assoc Pancreatol IAP Al 2012; 12: 156– 161. PMC4348043 22487526
  61. [72]Boursi B, Finkelman B, Giantonio BJ, A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With New-Onset Diabetes. Gastroenterology 2017; 152: 840– 850.e3. 27923728 PMC5337138
  62. [73]Sharma A, Kandlakunta H, Nagpal SJS, Model to Determine Risk of Pancreatic Cancer in Patients With New-Onset Diabetes. Gastroenterology 2018; 155: 730– 739.e3. 29775599 PMC6120785
  63. [74]Whitcomb DC, Frulloni L, Garg P, Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatol Off J Int Assoc Pancreatol IAP Al 2016; 16: 218– 224. PMC6042966 26924663
  64. [75]Raimondi S, Lowenfels AB, Morselli-Labate AM, Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol 2010; 24: 349– 358. 20510834
  65. [76]Hart PA, Conwell DL. Chronic Pancreatitis: Managing a Difficult Disease. Am J Gastroenterol November 2019. PMC6940526 31764092
  66. [77]Algül H, Treiber M, Lesina M, Mechanisms of disease: chronic inflammation and cancer in the pancreas--a potential role for pancreatic stellate cells? Nat Clin Pract Gastroenterol Hepatol 2007; 4: 454– 462. 17667994
  67. [78]Lowenfels AB, Maisonneuve P, Cavallini G, Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med 1993; 328: 1433– 1437. 8479461
  68. [79]Liao K-F, Lai S-W, Li C-I, Diabetes mellitus correlates with increased risk of pancreatic cancer: a population-based cohort study in Taiwan. J Gastroenterol Hepatol 2012; 27: 709– 713. 21929650
  69. [80]Rebours V, Boutron-Ruault M-C, Schnee M, Risk of pancreatic adenocarcinoma in patients with hereditary pancreatitis: a national exhaustive series. Am J Gastroenterol 2008; 103: 111– 119. 18184119
  70. [81]Shelton CA, Umapathy C, Stello K, Hereditary Pancreatitis in the United States: Survival and Rates of Pancreatic Cancer. Am J Gastroenterol 2018; 113: 1376. 30018304 PMC6708435
  71. [82]Rijkers AP, Bakker OJ, Ahmed Ali U, Risk of Pancreatic Cancer After a Primary Episode of Acute Pancreatitis. Pancreas 2017; 46: 1018– 1022. 28797012
  72. [83]Tummala P, Tariq SH, Chibnall JT, Clinical predictors of pancreatic carcinoma causing acute pancreatitis. Pancreas 2013; 42: 108– 113. 22722258
  73. [84]Munigala S, Kanwal F, Xian H, Increased risk of pancreatic adenocarcinoma after acute pancreatitis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2014; 12: 1143– 1150.e1. 24440214
  74. [85]Chung S-D, Chen K-Y, Xirasagar S, More than 9-times increased risk for pancreatic cancer among patients with acute pancreatitis in Chinese population. Pancreas 2012; 41: 142– 146. 21946811
  75. [86]Kirkegård J, Cronin-Fenton D, Heide-Jørgensen U, Acute Pancreatitis and Pancreatic Cancer Risk: A Nationwide Matched-Cohort Study in Denmark. Gastroenterology 2018; 154: 1729– 1736. 29432727

Cited by

Sorted by citations

Authors
Khalaf, N., El-Serag, H. B., Abrams, H. R., & Thrift, A. P.
Affiliations
  • Michael E. DeBakey VA Medical Center (US)
  • Baylor College of Medicine (US)
Corresponding author
Khalaf, Natalia
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2021-05
Volume
19
Issue
5
Pages
876-884
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2020.02.054
PMC
PMC8559554
OpenAlex
W3010042238
Cited by
308
References
9
Citations by year
2026: 36 · 2025: 46 · 2024: 56 · 2023: 73 · 2022: 63 · 2021: 26 · 2020: 7
FWCI
4.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases
Topics
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
Keywords
pancreatic cancer, cancer incidence, cancer mortality, SEER database, cancer surveillance, early detection, vulnerable populations, survival rate, incidence trends, risk factors, cancer prevention, age- and sex-specific incidence, racial disparities
MeSH terms
Humans, Pancreatic Neoplasms, Registries, Risk Factors, United States, Incidence, Survival Rate

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review