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The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

2019; Elsevier BV; Volume: 4; Issue: 12 Linguagem: Inglês

10.1016/s2468-1253(19)30347-4

2468-1253

Akram Pourshams, Sadaf G Sepanlou, Kevin S Ikuta, Catherine Bisignano, Saeid Safiri, Gholamreza Roshandel, Mehdi Sharif, Morteza Khatibian, Christina Fitzmaurice, Molly R Nixon, Nooshin Abbasi, Mohsen Afarideh, Elham Ahmadian, Tomi Akinyemiju, Fares Alahdab, Shazia Alam, Vahid Alipour, Christine A. Allen, Nahla Anber, Alireza Ansari-Moghaddam, Jalal Arabloo, Alaa Badawi, Mojtaba Bagherzadeh, Yaschilal Muche Belayneh, Belete Biadgo, Ali Bijani, Antonio Biondi, Tone Bjørge, Antonio Maria Borzì, Cristina Bosetti, Andrey Briko, Н. И. Брико, Giulia Carreras, Félix Carvalho, Jee-Young Jasmine Choi, Dinh‐Toi Chu, Anh Kim Dang, Ahmad Daryani, Dragoş Virgil Daviţoiu, Gebre Teklemariam Demoz, Rupak Desai, Subhojit Dey, Hoa Do, Huyen Phuc, Aziz Eftekhari, Alireza Esteghamati, Farshad Farzadfar, Eduarda Fernandes, Irina Filip, Florian Fischer, Masoud Foroutan, Mohamed M. Gad, Silvano Gallus, Birhanu Geta, Giuseppe Gorini, Nima Hafezi‐Nejad, James Harvey, Milad Hasankhani, Amir Hasanzadeh, Soheil Hassanipour, Simon I Hay, Hagos D Hidru, Chi Linh Hoang, Sorin Hostiuc, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena Ilić, Seyed Sina Naghibi Irvani, Nader Jafari Balalami, Spencer L James, Farahnaz Joukar, Amir Kasaeian, Tesfaye Kassa, André Pascal Kengne, Rovshan Khalilov, Ejaz Ahmad Khan, Amir M Khater, Fatemeh Khosravi Shadmani, Jonathan Kocarnik, Hamidreza Komaki, Ai Koyanagi, Vivek Kumar, Carlo La Vecchia, Platon D Lopukhov, Farzad Manafi, Navid Manafi, Ana-Laura Manda, Fariborz Mansour‐Ghanaei, Dhruv Mehta, Varshil Mehta, Toni Meier, Hagazi Gebre Meles, Getnet Mengistu, Tomasz Miazgowski, Mehdi Mohamadnejad, Abdollah Mohammadian-Hafshejani, Milad Mohammadoo-Khorasani, Shafiu Mohammed, Farnam Mohebi, Ali H. Mokdad, Lorenzo Monasta, Maryam Moossavi, Rahmatollah Moradzadeh, Gurudatta Naik, Ionuţ Negoi, Cuong Tat Nguyen, Long Hoang Nguyen, Trang Huyen Nguyen, Andrew T Olagunju, Tinuke O Olagunju, Alyssa Pennini, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Mahdi Rahimi, Goura Kishor Rath, David Laith Rawaf, Salman Rawaf, Robert C. Reiner, Nima Rezaei, Aziz Rezapour, Anas M. Saad, Seyedmohammad Saadatagah, Amirhossein Sahebkar, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Arash Sarveazad, Monika Sawhney, Mario Šekerija, P. I. Shabalkin, Masood Ali Shaikh, Rajesh Sharma, Sara Sheikhbahaei, Reza Shirkoohi, Sudeep K Siddappa Malleshappa, Mekonnen Sisay, Kjetil Søreide, Sergey Soshnikov, Rasoul Sotoudehmanesh, Vladimir I. Starodubov, Michelle L Subart, Rafael Tabarés‐Seisdedos, Degena Bahrey Tadesse, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Marco Vacante, Amir Vahedian‐Azimi, Elena A. Varavikova, Ronny Westerman, Dawit Dawit Zewdu Wondafrash, Rixing Xu, Naohiro Yonemoto, Vesna Zadnik, Zhi‐Jiang Zhang, Reza Malekzadeh, Mohsen Naghavi,

Childhood Cancer Survivors' Quality of Life

Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments.Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates.In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51·9%) were in males. The age-standardised incidence rate was 5·0 (4·9-5·1) per 100 000 person-years in 1990 and increased to 5·7 (5·6-5·8) per 100 000 person-years in 2017. There was a 2·3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2·1 times increase in DALYs due to pancreatic cancer, increasing from 4·4 million (4·3-4·5) in 1990 to 9·1 million (8·9-9·3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17·4 [15·8-19·0] per 100 000 person-years) and Uruguay (12·1 [10·9-13·5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1·9 [1·5-2·3] per 100 000 person-years) had the lowest rate in 2017, and São Tomé and Príncipe (1·3 [1·1-1·5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21·1% [18·8-23·7]), high fasting plasma glucose (8·9% [2·1-19·4]), and high body-mass index (6·2% [2·5-11·4]) in 2017.Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed.Bill & Melinda Gates Foundation.