Study analyzes shifting pancreatic cancer burdens in US and China

Pancreatic cancer is the sixth leading cause of cancer-related mortality worldwide, accounting for about 4.8% of cancer deaths, with an overall 5-year survival of approximately 12%. This study analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) using data from the Global Burden of Disease Study from 1990–2023. The researchers used Joinpoint regression to assess temporal trends, the slope index of inequality and concentration index for socioeconomic inequalities, and population attributable fractions (PAFs) to estimate the contributions of risk factors. The study was published in Volume 9, Issue 3 of the Journal of Pancreatology in September 2026.

In 2023, China had more prevalent cases than the United States (103,000 vs. 66,000) but lower age-standardized rates of prevalence (4.51 vs. 11.19 per 100,000), incidence (5.13 vs. 10.53), mortality (4.97 vs. 9.56), and DALYs (120.60 vs. 211.19). From 1990 to 2023, burden increased in both countries, with age-standardized DALYs declining slightly in China (−0.15% annually) and increasing in the United States (0.12%). Burden peaked at 65–74 years of age in China and 70–84 years in the United States. Male-to-female rate ratios peaked above 3.0 in China vs. below 1.6 in the United States.

Globally, burden remained concentrated in high socio-demographic index regions with widening absolute inequality: the slope index for prevalence rose from 11.88 in 1990 to 22.70 in 2023, while the concentration index changed from 0.52 to 0.55, indicating largely unchanged relative inequality.

Risk profiles changed substantially. In China, tobacco was the leading attributable risk factor in 1990 (PAF of 8.9%); by 2023 the PAF for high fasting plasma glucose reached 24.6% vs. 21.2% for tobacco, with no significant difference (P = 0.269). In the United States, tobacco was the leading attributable risk factor in 1990 with a PAF 11.5%. By 2023, high fasting plasma glucose had become the leading risk factor, with a PAF of 32.2%, significantly exceeding the 14.6% attributed to tobacco (P < 0.001). The authors conclude that rising fasting plasma glucose underscores the need for metabolic risk management in prevention, and note that the analysis was ecological and country-level, so findings should not be extrapolated to individual-level associations.