Pancreatic Cancer Mortality Research Articles

Trends and Variations in Pancreatic Cancer Mortality Among US Metro and Nonmetro Adults, 1999-2020.

Pancreatic cancer is the third leading cause of cancer deaths in the United States. Despite decreasing cancer mortality rates as a whole, pancreatic cancer death rates in the United States remain steady and demonstrate racial/ethnic disparities. Divergent cancer mortality trends have also been observed between metro and nonmetro populations. We therefore aimed to compare metro and nonmetro trends in pancreatic cancer mortality rates in the United States from 1999 to 2020 and investigate potential sex and racial/ethnic differences. We analyzed National Center for Health Statistics data for all pancreatic cancer deaths among individuals aged 25 years or older in the United States. We estimated the average annual percent change (AAPC) in age-standardized pancreatic cancer mortality rates in metro versus nonmetro areas by sex and race/ethnicity. Of the total 810,425 pancreatic cancer-related deaths identified from 1999 to 2020, 668,547 occurred in metro areas and 141,878 in nonmetro areas. Non-Hispanic Black individuals had the highest rates of pancreatic cancer mortality regardless of metropolitan status. In both metro and nonmetro areas, pancreatic cancer mortality rates among non-Hispanic White individuals increased over the study period (AAPC: metro, males, 0.32%; females, 0.27%; nonmetro, males, 0.77%; females, 0.62%). Non-Hispanic Black individuals in metro areas had a decrease in pancreatic cancer mortality (AAPC: males, -0.25%; females, -0.29%), but rates among non-Hispanic Black women in nonmetro areas increased (AAPC, 0.49%). There are variations not only in pancreatic cancer mortality by metro and nonmetro status but also by sex and race/ethnicity within these areas. Individuals who live in nonmetro areas have higher pancreatic cancer mortality rates and increasing death rates compared with their metro counterparts. These findings highlight the need for targeted cancer prevention strategies that are specific to metro or nonmetro populations.

Epidemiology of pancreatic cancer in Ukraine and Zaporizhzhia region

The aim of the work is to analyze the incidence and mortality of pancreatic cancer (PC) in Ukraine and the Zaporizhzhia region to highlight and compare the organization of oncological care, the benefits of prevention, and early diagnosis of this disease. Materials and methods. The analysis of the data of the National Cancer Registry of Ukraine for 2014–2022 was carried out. The information used in the research was reviewed and approved by the Commission on Bioethics of Zaporizhzhia State Medical and Pharmaceutical University, an extract from protocol No. 10 dated 12/21/2023. The data analysis was carried out using Microsoft Excel spreadsheets and the applied statistical program Statistica® for Windows 13.0 (StatSoft Inc., USA, license No. JPZ804I382130ARCN10-J). Results. According to GLOBOCAN data (2022), RP ranks 14th in the world and 12th in Ukraine in morbidity and is one of the leading causes of mortality. Every year there is an increase in cases of this pathology. Morbidity and mortality rates are significantly higher in countries with a high level of development, while the survival rate does not reveal such a dependence. Mortality from PC in Ukraine is 76.9–82.3 %, in the Zaporizhzhia region 86.2–99.5 % with positive dynamics. Detection of early stages of PC in Ukraine and the Zaporizhzhia region is at the level of 26.0–36.4 %, 30.7–43.6 %, respectively, diagnosis of advanced stages is at the level of 43.8–56.3 % across Ukraine, in the Zaporizhzhia region – 58.6–63.2 %. In Ukraine, 25.3–31.9 % of primary patients are covered by special treatment, the regional indicator is 17.9–26.6 % with positive dynamics. The effectiveness of primary prevention of PC in Ukraine reaches 3.3 %, the regional indicator does not exceed 3.0 %. Conclusions. Improvement of preventive measures, selection of groups at risk of development of PC, modification of lifestyle are factors for improvement of prognosis and survival of patients with PC.

Portal vein thrombosis in gastrointestinal cancers: Insights into prevalence and prognosis—A nationwide inpatient analysis 2018-2020.

e16382 Background: The relation between cancer and thrombotic events has been well established over the past decade. Cancer is a prothrombotic state and thrombosis is the second most common cause of death in cancer. While portal vein thrombosis (PVT) has been extensively studied in individuals with Hepatocellular Carcinoma (HCC), its significance in other Gastrointestinal (GI) cancers is often overlooked. This study aims to investigate the prevalence and prognostic impact of PVT across various GI cancers. Methods: A retrospective analysis was performed on the National Inpatient Sample database (2018-2020) and the ICD-10 codes to identify the patients > 18 years old with primary diagnosis of GI cancers (pancreatic, HCC, gastric, small intestinal[SI], colorectal). Prevalence of PVT in individual GI cancers and effect of PVT on mortality, length of stay and Hospital cost utilization was studied. Multivariable regression analyses were performed adjusting for demographics, hospital-level characteristics, and relevant comorbidities. These included Age, Sex, Race, obesity, Smoking, Hypertension, Diabetes, CKD, liver disease, CHF, CAD, Hypothyroidism. Results: Our study analyzed data from 2,313,888 individuals with GI cancers, Including HCC, Gastric cancer, SI cancer, colorectal and pancreatic cancer, The incidence of PVT varied across cancer types, with 12.9% in pancreatic cancer, 0.74% in HCC, 0.99% in gastric cancer, 0.47% in colorectal cancer, and 3.6% in pancreatic cancer. Multivariate regression analysis, adjusting for confounders, revealed a significant association between PVT and increased mortality in various GI cancers. Specifically, the odds ratio (OR) for mortality in pancreatic cancer was 1.31 (p < 0.001), in HCC was 1.39 (p < 0.001), in gastric cancer was 1.88 (p < 0.001), and in colorectal cancer was 2.10 (p < 0.001). However, the incidence of mortality in SI cancer did not yield a significant result OR 1.42 [p- value 0.369] [Table 1]. Additionally, Our findings revealed an increase in length of stay and total healthcare resource utilization across all GI cancers for individuals with PVT compared to without PVT. Conclusions: There is a statistically significant effect of symptomatic and asymptomatic PVT on mortality in various other GI cancers in addition to HCC, which has been established and studied widely. Further prospective studies are needed to study the effect of diagnosing PVT earlier in the disease to predict mortality and other major complications in GI cancers.[Table: see text]

Pancreatic cancer in Saudi Arabia (2005–2020): increasing trend

Pancreatic cancer, a highly fatal malignancy, has shown a global rise in the incidence and mortality rates. However, these rates vary significantly across different regions worldwide. This study aims to assess the incidence and mortality of pancreatic cancer in Saudi Arabia. We collected the data from 16 annual cancer incidence reports in Saudi Arabia for the study period (2005–2020) and from the WHO's IARC Global Cancer Observatory website. Although the burden of pancreatic cancer in Saudi Arabia is relatively lower compared to global rates, the disease incidence has shown a steady increase over the study period, in addition to regional variations within the country. The disease predominantly affects the elderly population, aged 50 years and above in both genders, with males exhibiting higher rates than females. Further studies are required to identify the potential risk factors for pancreatic cancer in the Saudi population.

Response to editorial: Gastric and pancreatic cancer trends in Spain.

This response to an editorial discusses recent trends in gastric and pancreatic cancer mortality in Spain. The authors acknowledge the contrasting trajectories - a decrease in gastric cancer and an increase in pancreatic cancer - and attribute them to differing causes. Public health measures, particularly H. pylori eradication, are credited for the decline in gastric cancer. The authors also present unpublished data showing a worrying rise in gastric cancer diagnoses among young men. They emphasize the need for continued monitoring, early detection strategies, and preventative measures to tackle both cancers, particularly focusing on pancreatic cancer research due to its rising mortality.

Trends in socioeconomic inequalities in pancreatic cancer mortality in Canada: Evidence from the Canadian Vital Statistics Death Database

BackgroundPancreatic cancer is one of the leading causes of death in Canada and is projected to be the second leading cause of cancer death by 2030. This study sought to evaluate education and income inequalities in pancreatic cancer mortality in Canada between 1990 and 2019. MethodsUsing a unique census division level dataset (n = 280) constructed from the Canadian Vital Statistics Death Database, Canadian Census of Population (1991, 1996, 2001, 2006, 2016), and National Household Survey (2011) we assess socioeconomic inequalities in pancreatic cancer in Canada. Age-standardized Concentration index was used to quantify income and education inequalities in pancreatic cancer mortality. Trends analyses were conducted to assess changes in income and education inequalities in pancreatic cancer mortality over time. ResultsOur results show that crude pancreatic cancer mortality in Canada increased significantly from 10.23 for males and 9.65 for females in 1990, to 15.99 for males and 14.28 for females in 2019, per 100,000 people. The statistically significant negative values of age-standardized Concentration indices suggest persistent income and education inequalities in pancreatic cancer mortality in Canada. Trend analyses indicates reductions in income and education inequalities in pancreatic cancer mortality over time, particularly among females. ConclusionsSignificant income and education inequalities in pancreatic cancer mortality in Canada warrant public policy concern and action. Further research is required to understand whether differential access to treatment across socioeconomic groups played a role in the observed socioeconomic inequalities.

The Association between Use of Renin-Angiotensin-Aldosterone System Inhibitors and the Risk and Mortality of Pancreatic Cancer: A Systematic Review and Meta-Analysis.

Pancreatic Cancer (PC) is one of the most malignant tumors and highly invasive neoplasms around the world. This systematic review and meta-analysis aims to study the relationship between the use of renin-angiotensin-aldosterone system inhibitors and the incidence and mortality of PC. The electronic search was conducted systematically until October 10, 2023. in databases, including Scopus, Web of Science (WOS), PubMed/MEDLINE, Cochrane Library, and Embase. The required data were extracted from the articles and were analyzed by Stata 15 using statistical tests (Chi-square and I2), Forest plots, and publication bias tests (Begg's and Egger's tests). A total of four studies (2011-2019; n=314,856) investigated the relationship between RAS antagonists and PC risk. No significant associations were found between angiotensin receptor blockers (ARBs) (OR=0.94, 95% CI: 0.77-1.14, p=0.513), angiotensin-converting enzyme inhibitors (ACEIs) (OR=0.96, 95% CI: 0.84-1.09, p=0.505), or combination therapy (ARBs + ACEIs) (OR=0.97, 95% CI: 0.87-1.09, p=0.627) and PC risk. Also, nine studies (2010-2023; n=20,483) examined the association between renin-angiotensin-aldosterone system inhibitors and PC mortality. Significant reductions in PC mortality were found for ARBs (OR=0.81, 95% CI: 0.66-0.98, p=0.032), ACEIs (OR=0.89, 95% CI: 0.80-0.99, p=0.038), and combination therapy (OR=0.83, 95% CI: 0.70-0.97, p=0.022). No evidence of publication bias was found in the study results. In summary, while renin-angiotensin-aldosterone system inhibitors did not appear to impact PC risk, their use was associated with lower PC mortality based on this meta-analysis of the current evidence. More rigorous and well-designed studies are required to validate and support these findings.

Calix[6]arene dismantles extracellular vesicle biogenesis and metalloproteinases that support pancreatic cancer hallmarks

Many challenges are faced in pancreatic cancer treatment due to late diagnosis and poor prognosis because of high recurrence and metastasis. Extracellular vesicles (EVs) and matrix metalloproteinases (MMPs), besides acting in intercellular communication, are key players in the cancer cell plasticity responsible for initiating metastasis. Therefore, these entities provide valuable targets for the development of better treatments. In this context, this study aimed to evaluate the potential of calix[6]arene to disturb the release of EVs and the activity of MMPs in pancreatic cancer cells. We found a correlation between the endocytic-associated mediators and the prognosis of pancreatic cancer patients. We observed a more active EV machinery in the pancreatic cancer cell line PANC-1, which was reduced three-fold by treatment with calix[6]arene at subtoxic concentration (5 μM; p 〈0,001). We observed the modulation of 186 microRNAs (164 miRNAs upregulated and 22 miRNAs downregulated) upon calix[6]arene treatment. Interestingly, some of them as miR-4443 and miR-3909, regulates genes HIF1A e KIF13A that are well known to play a role in transport of vesicles. Furthermore, Calix[6]arene downmodulated matrix metalloproteinases (MMPs) -2 and − 9 and disturbed the viability of pancreatic organoids which recapitulate the cellular heterogeneity, structure, and functions of primary tissues. Our findings shed new insights on calix[6]arene's antitumor mechanism, including its intracellular effects on vesicle production and trafficking, as well as MMP activity, which may harm the tumor microenvironment and contribute to a reduction in cancer cell dissemination, which is one of the challenges associated with high mortality in pancreatic cancer.

Abstract 4427: Do changes in lipid metabolism link obesity to pancreatic cancer

Abstract The near equal incidence and mortality rates of pancreatic cancer, combined with projections that pancreatic cancer will become the second-most common cancer-related deaths by 2050, underscore the need to identify patients with early disease and interrupt this trajectory. Obesity, weight gain and waistline have been implicated in increasing the risk of pancreatic cancer. Although metabolomic analyses of pancreatic cancer patients have established correlations between phospholipids, lysophospholipids with treatment outcomes, the association between metabolites, obesity, and pancreatic cancer remains largely understudied. The objective of this pilot study was to determine differences in serum metabolites in obese and overweight pancreatic cancer patients compared with healthy non-obese subjects. Our long-term goal is to develop serum marker(s) that may be used to prevent advanced pancreatic cancer and thus improve outcomes for these patients. Serum was obtained from healthy subjects (n=11; BMI range from 18-25), overweight (n=9; 25-30) and obese (n=7; >30) pancreatic cancer patients from an IRB approved study. Males (n=12) and females (n=15) were represented in the study. Global metabolic profiles were determined using Ultrahigh performance liquid chromatography-tandem mass spectroscopy. Raw data was extracted, peaks were identified and processed at Metabolon using the Laboratory Information Management System. Comparison between overweight pancreatic cancer patients and healthy controls identified 403 biochemicals (111 upregulated and 292 downregulated; p <0.05) and 93 biochemicals (40 upregulated and 53 downregulated; 0.05<p<0.10). Comparison of the differences in biochemicals between obese pancreatic cancer patients and healthy controls showed changes in 293 biochemicals (71 upregulated and 222 downregulated; p <0.05) and 123 biochemical changes at 0.05<p<0.10 (42 increased and 81 decreased). 38 (p <0.05) and 47 (0.05<p<0.10) differential levels of biochemicals were identified when obese and overweight pancreatic cancer patients were compared. Random forest analysis showed that the 30 top ranking biochemicals were involved in lipid metabolism, amino acid metabolism, nucleotide metabolism, peptide, xenobiotics, and carbohydrate metabolism. These data suggest an association between changes in lipid metabolism may be another link between obesity and pancreatic cancer. This project was funded in part by VA-Merit Award (I01 BX003876). Citation Format: Rita Ghosh, Deepa Ajit, Jillian Woodworth, Danielle Fritze, Francisco G. Cigarroa, Glenn A. Halff, Addanki Pratap Kumar. Do changes in lipid metabolism link obesity to pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4427.

Abstract 4253: High expression of specific gene profiles in organoids from African American pancreatic cancer tumors

Abstract Pancreatic cancer remains one of the leading causes of cancer-related deaths in the United States with limited therapies for advanced stages of this disease. African Americans have the highest morbidity and mortality rates of pancreatic cancer compared to other racial groups. Many factors are known to contribute to this disparity such as, socioeconomic and lifestyle factors. One of the major factors contributing to this disparity is the lack of African Americans with pancreatic cancer in clinical trials or genomic databases. In order to gain insight into the biology or genetic differences that may exist in signals driving the aggressiveness of this cancer in this population more studies are needed. Innovative in vitro models are needed to investigate possible differences in molecular changes that may exist in African Americans. Studies have shown that organoids developed from metastatic and primary tumors can give sights into genetic and epigenetic changes detected in several type of cancers. Using a Human Pancreatic Adenocarcinoma TagMan Array 96 (Applied Biosystems), which contained 76 genes known to be expressed in pancreatic cancer, pancreatic organoids from African American metastatic tumors revealed high expression levels of specific genes. Usually K-ras is highly expressed in pancreatic tumors but it was not significantly expressed in the organoids from African Americans metastatic tumors. However, preliminary results from organoids, compared to pancreatic cancer cell line spheroids, showed significantly increased gene expression of HSP90AA1 (13-fold), MMP1(36-fold), BRACA2 (20-fold), MDM2 (19-fold), RB1 (14-fold), Rel (12-fold), STAT1 (15-fold), STAT5B (5-fold), and TGFBR1 (1- fold). High expression of HSP90AA1 is related to poor prognosis, constitutively expression of STAT5B confers gemcitabine chemoresistance and promote invasiveness, and mutations in BRCA2 can increase pancreatic cancer risk. Further studies are being done to validate these findings in African American pancreatic tumors and to ascertain their relevance to the metastatic progression phenotype. Citation Format: Beverly D. Lyn-Cook, Fatemeh Nouri Emamzaden, Beverly Word, George Hammons. High expression of specific gene profiles in organoids from African American pancreatic cancer tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4253.

Abstract B007: Early detection and risk stratification of pancreatic cancer using apolipoprotein A2-isoforms as a blood biomarker

Abstract To reduce the mortality rate of pancreatic cancer, there is an urgent need to develop a biomarker that can efficiently screen for pancreatic cancer in blood tests. We had identified the unique processing of C-terminal amino acids of apolipoprotein A2 homodimers, we named it apolipoprotein A2-isoforms (apoA2-i). ApoA2-i consists of three isoforms with different C-terminal amino acids. Especially, we had reported that apoA2-ATQ/AT, known as the intermediate isoform, was significantly reduced in the bloodstream of pancreatic adenocarcinoma (PDAC) patients compared to healthy controls. However, previous reports were investigated using a research use only (RUO) reagent, which could not be used in clinical settings. We generated a novel ELISA for measuring apoA2-i under the Japanese medical device Quality Management System requirements, and measured the concentration of apoA2-i in 2,732 of plasma samples. The clinical equivariance and significance of apoA2i were evaluated by pre-specified endpoints. The point estimate of the area under the curve to distinguish between PDAC and healthy controls was higher for apoA2-ATQ/AT [0.879, 95% confidence interval (CI): 0.832–0.925] than for CA19-9 (0.849, 95%CI: 0.793–0.905) and achieved the primary endpoint. The cut-off apoA2-ATQ/AT of 59.5 μg/mL was defined based on 95% specificity in 2,000 healthy samples. The sensitivity of apoA2-ATQ/AT for detecting both stage I (47.4%) and I/II (50%) of PDAC was higher than that of CA19-9 (36.8% and 46.7%, respectively). The combination of apoA2-ATQ/AT (cut-off, 59.5 μg/mL) and CA19-9 (37 U/mL) increased the sensitivity for pancreatic cancer to 87.7% compared with 69.8% for CA19-9 alone. ApoA2-ATQ/AT has equivalent or better clinical performance to CA19-9 as a blood biomarker. Citation Format: Kazufumi Honda, Ayumi H. Kashiro, Michimoto Kobayashi, Keiko Takeuchi, Yuya Shizume, Takanori Oh, Chigusa Morizane, Susumu Hijioka, Satoshi Nara. Early detection and risk stratification of pancreatic cancer using apolipoprotein A2-isoforms as a blood biomarker [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr B007.

Pancreatic cancer progression and mortality predicted by depression and anxiety: a systematic review and meta-analysis protocol.

Although the relationship between psychological factors and pancreatic cancer outcomes has been widely discussed, controversy remains. We will for the first time systematically summarize the literature to explore the correlation of anxiety and depression to the prognosis of patients with pancreatic cancer. The findings will fill existing research gaps, informing healthcare providers about better psychological care and medical treatment. The following databases will be retrieved from their inception to July 2023: Cochrane Library, MEDLINE (PubMed), Web of Science, EMBASE, and four Chinese databases (Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chongqing VIP Chinese Science and Technology Periodical Database). The World Health Organization Clinical Trials Registry, Chinese Clinical Registry, and ClinicalTrials.gov will be searched to identify other related studies. A manual search will be performed to identify missing eligible studies based on the reference list of selected articles. The search will focus on studies published in Chinese or English. To assess the risk of bias in the selected articles, Newcastle-Ottawa Quality Assessment Scale (NOS) will be used for the cohort study. Funnel plots and Egger's test will be used to assess whether publication bias exists. Moreover, the Grading of Recommendations Assessment Development and Evaluation (GRADE) will be utilized to analyze the credibility of the results from selected articles. Two independent evaluators will implement the study selection and data extraction, as well as evaluate the risk of bias and evidence quality. Data will be analyzed using Stata 16.0. Trial registration: PROSPERO registration number is CRD42022366232.

The association between circulating 25-hydroxyvitamin D and pancreatic cancer: a systematic review and meta-analysis of observational studies.

The relationship between circulating 25-hydroxyvitamin D [25(OH)D] and pancreatic cancer has been well studied but remains unclear. The purpose of this study was to elucidate the association between circulating 25(OH)D and pancreatic cancer by using a meta-analytic approach. PubMed, Embase, and Wed of Science databases were searched through October 15, 2022. A random or fixed-effects model was used to estimate the pooled odds ratio (OR), risk ratio (RR), hazard ratio (HR) and their 95% confidence intervals (CIs). A total of 16 studies including 529,917 participants met the inclusion criteria, of which 10 reported incidence and 6 reported mortality. For the highest versus lowest categories of circulating 25(OH)D, the pooled OR of pancreatic cancer incidence in case-control studies was 0.98 (95% CI 0.69-1.27), and the pooled HRs of pancreatic cancer mortality in cohort and case-control studies were 0.64 (95% CI 0.45-0.82) and 0.78 (95% CI 0.62-0.95), respectively. The leave-one-out sensitivity analyses found no outliers and Galbraith plots indicated no substantial heterogeneity. Evidence from this meta-analysis suggested that high circulating 25(OH)D levels may be associated with decreased mortality but not incidence of pancreatic cancer. Our findings may provide some clues for the treatment of pancreatic cancer and remind us to be cautious about widespread vitamin D supplementation for the prevention of pancreatic cancer.

Different trends in stomach and pancreatic cancer mortality rates.

Not so long ago stomach cancer used to be the most frequent digestive cancer in both sexes in Spain and other Western countries. However, due to the decreasing trend of this disease over the last few decades, gastric cancer ranks seventh and eighth in Spanish women and men, respectively, as a cancer-related cause of death, while being the fourth most frequent digestive cancer, after colorectal, pancreatic and liver cancer. On the other hand, pancreatic cancer mortality figures have been continually increasing, and nowadays this malignancy ranks second among digestive cancers in terms of mortality in both sexes. The distinct trends of stomach and pancreatic cancer mortality rates might be explained by changes in exposure to risk factors, mainly to H. pylori eradication. Notably, these tumors share several modifiable risk factors, such as tobacco consumption, obesity, and physical inactivity. Since these risk factors are also associated with many other cancers, effective cancer prevention strategies are needed to reduce the risk of developing cancer in the population.

Pancreatic cancer mortality trends attributable to high fasting blood sugar over the period 1990-2019 and projections up to 2040.

Pancreatic cancer (PC) is a prevalent malignancy within the digestive system, with diabetes recognized as one of its well-established risk factors. Data on PC mortality attributed to high fasting blood sugar were retrieved from the Global Burden of Disease (GBD) study 2019 online database. To assess the temporal trends of PC burden attributable to high fasting plasma glucose (HFPG), estimated annual percentage changes (EAPCs) for age-standardized death rates (ASDRs) between 1990 and 2019 were determined using a generalized linear model. Furthermore, a Bayesian age-period-cohort (BAPC) model using the integrated nested Laplacian approximation algorithm was employed to project the disease burden over the next 20 years. Globally, the crude death number of PC attributable to HFPG almost tripled (from 13,065.7 in 1990 to 48,358.5 in 2019) from 1990 to 2019, and the ASDR increased from 0.36/100,000 to 0.61/100,000 with an EAPC of 2.04 (95% CI 1.91-2.16). The population aged ≥70 years accounted for nearly 60% of total deaths in 2019 and experienced a more significant increase, with the death number increasing approximately fourfold and the ASDR increasing annually by 2.65%. In regions with different sociodemographic indexes (SDIs), the highest disease burden was observed in the high-SDI region, whereas more pronounced increasing trends in ASDR were observed in the low to middle-SDI, low-SDI, and middle-SDI regions. Additionally, a significantly negative association was found between EAPCs and ASDRs of PC attributable to HFPG from 1990 to 2019. Moreover, the BAPC model predicts that ASDR and age-standardized disability-adjusted life-years (DALYs) rate for PC attributed to HFPG was projected to increase obviously for men and women from 2019 to 2040. The burden of PC attributed to HFPG has increased globally over the past three decades, with the elderly population and high-SDI regions carrying a relatively greater disease burden, but more adverse trends observed in low-SDI areas. Furthermore, the burden is projected to continue increasing over the next 20 years. Hence, more tailored prevention methodologies should be established to mitigate this increasing trend.

Pancreatic cancer mortality in South Africa: A case-control study

Background. There are variations in the numbers of pancreatic cancer deaths reported annually in South Africa (SA). Since pancreatic cancer deaths in SA from 1997 to 2016, the number of cases has hugely increased, and reached 23 581 in both sexes. Sex differences are likely to contribute to the variations in the strength of associations between the risk factors and pancreatic cancer mortality. Objective. To identify factors associated with an increased risk of pancreatic cancer mortality in SA. Methods. A matched case-control study with 1:1 matching was conducted using data collected by Statistics SA from 1997 to 2016. Controls were randomly selected to be as similar as possible to the cases, and matched by age, sex and year of death. Conditional logistic regression was used to identify factors associated with pancreatic cancer mortality. Results. This case-control study comprised a final selection of 23 581 cases (12 171 males and 11 410 females) and 23 581 controls (12 171 males and 11 410 females). A significantly increased risk of pancreatic cancer mortality was observed among males who were managers (odds ratio (OR) 2.99; 95% confidence interval (CI) 1.36 - 6.60; p=0.006) and craft and related trade workers (OR 1.89; 95% CI 1.14 - 3.14; p=0.013). Elevated risks of pancreatic cancer mortality were also found among females who were managers (OR 6.13; 95% CI 1.32 - 28.52; p=0.021), professionals (OR 2.12; 95% CI 1.24 - 3.63; p=0.006), clerical support workers (OR 3.78; 95% CI 1.79 - 7.98; p=0.001) and elementary occupation workers (OR 1.41; 95% CI 0.99 - 2.00; p=0.059). Smoking was significantly associated with pancreatic cancer mortality in females (OR 1.36; 95% CI 1.02 - 1.82; p=0.039). Working in several occupations was associated with an increased risk of pancreatic cancer mortality in males (OR 1.31; 95% CI 1.01 - 1.71; p=0.045) and females (OR 1.66; 95% CI 1.30 - 2.12; p<0.001). Conclusion. Smoking and certain occupations increased the risk of pancreatic cancer mortality. Further research is needed to evaluate the associations between other extrinsic and intrinsic factors and pancreatic cancer mortality.

An AI-Driven Clinical Text-Based Decision Support System for Pancreatic Cancer Diagnosis

The high mortality rate of pancreatic cancer and its detection at a late stage require advanced early diagnostic methods. The proposed AI-based clinical decision support system that leverages natural language processing (NLP) to extract key information from medical texts, such as patient records and reports. Using machine learning algorithms, including recurrent neural networks and transformer models, the system aims to identify early signs of pancreatic cancer with high accuracy. This research aims to bridge the gap between the increasing complexity of medical data and the need for user-friendly diagnostic tools. The model focus on a text analytics approach, integrating NLP techniques such as named entity recognition and sentiment analysis with machine learning for predictive modeling. The system interface will help healthcare professionals make informed decisions with a great accuracy for treatment recommendations. By facilitating early detection and providing actionable insights, the model hopes to significantly reduce the burden of pancreatic cancer.

The perfect trio to decrease mortality in pancreatic cancers: Molecular marker screening tests with biosensors in precancerous lesions

The mortality rates of pancreatic cancer (PC) are very high. The methods recommended in the studies conducted to date have been able to reduce mortality very little. This study aimed to review studies on this subject and to identify the most appropriate methods to decrease mortality in PCs. Therefore, research articles and reviews on this subject were analyzed intensely, and the findings were summarized. According to the results obtained in our study, to decrease mortality in pancreatic ductal adenocarcinomas, early diagnostic screening should be performed primarily with molecular markers and biosensors effective in precancerous lesions in risk groups. However, studies on such screening worldwide have not yet been conducted. Therefore, further research is needed to arrive at more precise conclusions.

Pancreatic cancer: the insidious, deadly malignancy

Unlike many other malignancies, mortality rates for pancreatic cancer have remained stubbornly stable, mainly reflecting the cancer's typically late presentation, ambiguous symptoms and a lack of research. However, scientists have now identified early biomarkers and patient risk factors that should help to detect this increasingly common malignancy while it remains curable.

Waste incineration and cancer mortality: a longitudinal controlled population-based study

Abstract Background Waste incinerator emissions have been associated with the possibility of increased risk for some cancers. Indeed, emissions are usually composed of heavy metals, dioxins, and furans, including carcinogens. Although emissions levels of incineration activity are considered safe, evidence about the impact of long-term human exposure to low dosages is lacking. We performed a longitudinal population-based study to compare cancer mortality rates between a geographical area exposed to pollutant emissions due to waste incineration and combined local industry activity, a non-exposed control area, and a reference (larger) area. Methods Exposed area was defined according to pollutants dispersion models, considering predominant wind intensity and direction. The control area was defined as near-to-the-exposed parishes unaffected by the pollutants emitted at the location where the incinerator is situated. Another larger area (“Large Lisbon”) was also considered as the reference area. Data about cancer mortality was provided by the Portuguese National Statistics Institute. Relative risks (RR) compared standardized (age and sex) specific mortality rates due to malignant neoplasms (ICD-9 and ICD-10) between the exposed area and (a) control are and (b) reference area. Results In the first five years of the waste incinerator activity (2000-2004), the RR for each cancer-related mortality was not statistically significant (considering either control or reference areas). Considering the average mortality rates between 2015 and 2019 for exposed versus control area, we found increased RR for hepatic and biliary tract (RR = 1.50; 95%CI:1.15-1.85), pancreatic (RR = 1.37; 95%CI:1.06-1.67), and respiratory tract cancer (RR = 1.24; 95%CI:1.07-1.41). No significant RR was found when comparing the exposed with the reference area. Conclusions Strengthening public health surveillance systems is pivotal to assess air pollution's impact on health. Key messages • Exposure to emissions from an industrial region including a waste incinerator plant was found to have increased risk for hepatic and biliary tract, pancreatic, and respiratory tract cancer mortality. • Surveillance systems are needed to continuously monitor how long-term exposure to low concentrations of carcinogenic substances from waste incinerator emissions impacts on population’s health.