Incidence, prevalence and mortality of hepatobiliary & pancreatic malignancies at the global and regional level: 1990 to 2016. GBD 2016 study

Abstract

Background: Cancer is the second most common cause of death. We aim to determine the incidence, prevalence, and mortality trends for HPB malignancy at a Global/Regional levels. We report on disability-adjusted life years (DALYs), and years lost to disability (YLD). Methods: The Global Burden of Disease (GBD) 2016 dataset was interrogated for end point variables by age, sex, year, and geography from 1990 to 2016. Data was modeled in DisMod-MR 2.1. Results are expressed as age-standardized rates (ASR). Results: The global ASIR for primary liver and pancreatic neoplasm rose from 12.49 to 14.55 and 6.11 to 6.37 (1990 to 2016); an increase of 17.87% and 6.25%, respectively. In contrast, the ASIR for biliary cancer decreased from 3.71 to 2.8, a decrease of 24.5%. In addition, the global ASPR for primary liver, pancreatic, and biliary cancers all increased 75.27%, 13.44%, and 31.15%, respectively. Global ASMR stayed constant for primary liver and pancreatic cancer. Interestingly, biliary cancer saw a global decrease in ASMR of 23.77%. The global DALY's decreased for primary liver, pancreatic, and biliary cancers. In contrast, the YLD rose for primary liver cancers 22.3%, stayed relatively constant for pancreatic cancer, yet fell slightly for biliary cancer. High-Income Asia Pacific had the highest ASR of incidence for pancreatic and biliary cancers, yet was the second highest incidence of primary liver cancers. Conclusions: The incidence/prevalence of HPB malignancies has seen an overall increased with no change in mortality rates, albeit a significant geographical variation. DALY's have decreased for HPB neoplasms.