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Cited by 270Pancreatic and Hepatic Oncology ResearchGlobal Cancer Incidence and ScreeningPancreatitis Pathology and Treatment

Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis

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Blackford, Amanda L, Canto, Marcia Irene, Klein, Alison P, Hruban, Ralph H, Goggins, Michael·2020·JNCI: Journal of the National Cancer Institute
DOI 10.1093/jnci/djaa004PMC PMC7669234
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Abstract

Background: Rapid access to pancreatic imaging and regular pancreatic surveillance may help identify stage I pancreatic cancer. We investigated recent trends in the stage of newly diagnosed pancreatic ductal adenocarcinoma (PDACs), age at diagnosis, and survival. Methods: Trends in age-adjusted incidence of stage IA PDAC between 2004 and 2016 were determined from the National Cancer Institute’s Surveillance, Epidemiology and End Results database. All tests were two-sided. Results: The incidence of stage IA PDAC cases diagnosed increased statistically significantly from 2004 to 2016 (annual percent change = 14.5, 95% confidence interval [CI] = 11.4 to 17.7; P < .001). During the study period, average age at diagnosis for stage IA and IB casesAQ3 declined by 3.5 years (95% CI = 1.2 to 5.9; P = .004) and 5.5 years (95% CI = 3.4 to 7.6; P < .001), whereas average age increased for higher-stage cases (by 0.6 to 1.4 years). Among stage IA cases, the proportion of blacks was smaller (10.2% vs 12.5%), and the proportion of other non-Caucasians was higher compared with higher-stage cases (11.9% vs 8.4%; P < .001). Stage IA cases were more likely to carry insurance (vs Medicaid or none) than higher-stage cases (cases aged younger than 65 years; odds ratio = 2.45, 95% CI = 1.96 to 3.06; P < .001). The 5-year overall survival for stage IA PDAC improved from 44.7% (95% CI = 31.4 to 63.7) in 2004 to 83.7% (95% CI = 78.6% to 89.2%) in 2012; 10-year survival improved from 36.7% (95% CI = 24.1 to 55.8) in 2004 to 49.0% (95% CI = 37.2% to 64.6%) in 2007. Conclusions: In recent years, the proportion of patients diagnosed with stage IA PDAC has increased, their average age at diagnosis has decreased, and their overall survival has improved. These trends may be the result of improved early diagnosis and early detection.

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  • Over time, the proportion of patients with very early-stage PDAC (stages IA and IB) has increased and the survival of these patients has improved, such that the 5-year survival for stage IA is in excess of 80%.

    “In fact, over time, the proportion of patients with very early-stage PDAC (stages IA and IB) has increased and the survival of these patients has improved,15 such that the 5-year survival for stage IA (node-negative PDAC measuring <2 cm) is in excess of 80%.16”

    From Artificial Intelligence and Early Detection of Pancreatic Cancer: 2020 Summative Review (2021) · cites this paper as [16]

  • In retrospective analyses of a US national cancer surveillance database, about 80% of patients with Stage IA/IB PDAC were alive at five years, compared with less than 10% of those with advanced disease.

    “a remarkable 80% of patients who present with the lowest stages of PDAC (Stage IA or IB disease) were alive at five years, compared to less than 10% of patients with advanced disease19.”

    From Pancreatic cancer: Advances and challenges (2023) · cites this paper as [19]

  • The proportion of stage I PDACs in CAPS5 is significantly higher than the national average (5.4% of 8,398 PDACs in SEER 2016 were stage I by surgical pathology; P < .00001).

    “Comparing the proportion of stage I PDACs to the national average is highly significant; in 2016, 5.4% of 8,398 PDACs in the SEER database (National Cancer Institute-SEER) were stage I by surgical pathology (P < .00001, Fisher's exact test).”

    From The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival (2022) · cites this paper as [3]

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Authors
Blackford, A. L., Canto, M. I., Klein, A. P., Hruban, R. H., & Goggins, M.
Affiliations
Johns Hopkins University (US)
Corresponding author
Goggins, Michael
ORCID
Venue
JNCI: Journal of the National Cancer Institute
Publisher
Oxford University Press (OUP)
Published
2020-01-20
Volume
112
Issue
11
Pages
1162-1169
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
DOI
10.1093/jnci/djaa004
PMC
PMC7669234
OpenAlex
W3001603296
Cited by
270
References
51
Citations by year
2026: 39 · 2025: 60 · 2024: 43 · 2023: 54 · 2022: 38 · 2021: 25 · 2020: 11
FWCI
11.55
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • JNCI Journal of the National Cancer Institute (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • NIH (U01CA210170, CA62924, R01CA176828, NCI P30 CA006973)
  • Stand Up To Cancer-Lustgarten Foundation Pancreatic Cancer Interception Translational Cancer Research Grant (SU2C-AACR-DT25–17)
  • American Association for Cancer Research
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 ductal adenocarcinoma, early-stage pancreatic cancer, incidence trends, age at diagnosis, overall survival, racial disparities, insurance status, pancreatic imaging, SEER, racial disparities in cancer outcomes, health insurance status
MeSH terms
Age Factors, Aged, Female, Humans, Male, Middle Aged, Neoplasm Staging, Pancreatic Neoplasms, United States, Incidence, Survival Rate, SEER Program, Carcinoma, Pancreatic Ductal

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