The increasing burden of pancreatic cancer in Brazil from 2000 to 2019: estimates from the Global Burden of Disease Study 2019.

Diogo Oliveira Chaves,Maria Teresa Bustamante Teixeira,Ana Paula Souto Melo,Valéria Maria De Azeredo Passos,Maximiliano Ribeiro Guerra,Alessandra Maciel Almeida,Aline Cândida Bastos

doi:10.1590/0037-8682-0271-2021

Abstract

INTRODUCTION: Pancreatic cancer is increasing worldwide. The burden of pancreatic cancer in Brazil and its states was analyzed and compared with that from the USA and China. METHODS: This is a descriptive study of the incidence and mortality estimates from the Global Burden of Disease 2019 study, from 2000 to 2019. The Brazilian states presenting the highest and lowest socio-demographic index (SDI) were selected from each of the five regions. The SDI consists of the per capita income, education, and fertility rate of each population. RESULTS: A significant increase was found in age-standardized incidence and mortality of pancreatic cancer in all three countries, with differences in magnitude and annual increases. In Brazil, this incidence rose from 5.33 [95% Uncertainty Interval (UI): 5.06- 5.51] to 6.16 (95% UI: 5.68- 6.53) per 100,000 inhabitants. China and the Brazilian states with the lowest SDI, such as Pará and Maranhão, showed lower incidence and mortality rates, although presenting the highest annual increases. No difference was found between the sexes. A higher mortality rate was observed for those individuals of 70+ years, which was three to four times higher than those aged 50 to 69 years. CONCLUSIONS: The increasing burden of pancreatic cancer in the studied countries, and the higher estimates for the elderly in a fast-aging country such as Brazil, indicates that more resources and health policies will be necessary. The greatest increase in the states with lower SDI reflects inequalities in the access to diagnosis and registries of this cancer.

Highlights

IntroductionResults: A significant increase was found in age-standardized incidence and mortality of pancreatic cancer in all three countries, with differences in magnitude and annual increases
This work is a descriptive study, analyzing the estimates of incidence, mortality, and years of life lost (YLL) for pancreatic cancer in Brazil and two counties used for comparison, according to place, sex, and age groups, between 2000 and 2019
The results of this study, using standardized methodology, converge with the findings of studies using other methodologies, which show a tendency for an increase in the burden of pancreatic cancer in Brazil and worldwide[1,2,3,6,18,19,21,22,23]

Summary

Introduction

Results: A significant increase was found in age-standardized incidence and mortality of pancreatic cancer in all three countries, with differences in magnitude and annual increases. China and the Brazilian states with the lowest SDI, such as Pará and Maranhão, showed lower incidence and mortality rates, presenting the highest annual increases. Conclusions: The increasing burden of pancreatic cancer in the studied countries, and the higher estimates for the elderly in a fast-aging country such as Brazil, indicates that more resources and health policies will be necessary. In Brazil, as well as in many countries around the world, mortality rates for pancreatic cancer have been increasing[1,2]. Between 2002 and 2015, an increase was reported in hospitalization rates, from 2.4 to 4.5/100,000 inhabitants, with an increase of 75% and 109% in each region of the country, mostly in state capitals[8]

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