Abstract
Administrative data are used to describe the pancreatic cancer (pcc) population. The analysis examines demographic details, incidence, site, survival, and factors influencing mortality in a cohort of individuals diagnosed with pcc. Incident cases of pcc diagnosed in Ontario between 1 January 2004 and 31 December 2011 were extracted from the Ontario Cancer Registry. They were linked by encrypted health card number to several administrative databases to obtain demographic and mortality information. Descriptive, bivariate, and survival analyses were conducted. During the period of interest, 9221 new cases of pcc (4548 in men, 4673 in women) were diagnosed, for an age-adjusted standardized annual incidence in the range of 8.6-9.5 per 100,000 population. Mean age at diagnosis was 70.3 ± 12.5 years (standard deviation). Five-year survival was 7.2% (12.8% for those <60 years of age and 3.6% for those >80 years of age). Survival varied by sex, older age, rural residence, lower income, site of involvement in the pancreas, and presence of comorbidity. The mortality rate in pcc is exceptionally high. With an increasing incidence and a mortality positively associated with age, additional support will be needed for this highly fatal disease as demographics in Ontario continue to trend toward a higher proportion of older individuals.
Highlights
Cancer of the pancreas is rare, and yet it accounts for the 4th largest number of cancer deaths in Canada each year
With an increasing incidence and a mortality positively associated with age, additional support will be needed for this highly fatal disease as demographics in Ontario continue to trend toward a higher proportion of older individuals
For patients with metastatic pcc, life expectancy approximates 2.5 months with best supportive care 6,7. New chemotherapy regimens such as folfirinox and nab-paclitaxel appear to offer longer life expectancy, but the improvement is accompanied by deleterious side effects and complications 8
Summary
Cancer of the pancreas is rare, and yet it accounts for the 4th largest number of cancer deaths in Canada each year. In 2014, 4700 new cases of pancreatic cancer (pcc) in Canada (9.3 per 100,000 population) were projected. Once a patient is diagnosed, prognosis is poor, with the number of deaths from pcc in 2014 estimated to be 4400 (8.6 per 100,000 population) 1. The mortality subsequent to most other cancers has declined since 2000, but no corresponding mortality improvement in pcc has occurred 3. For patients with metastatic pcc, life expectancy approximates 2.5 months with best supportive care 6,7. New chemotherapy regimens such as folfirinox and nab-paclitaxel appear to offer longer life expectancy (up to a median of 11 months), but the improvement is accompanied by deleterious side effects and complications 8
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