A Population-Based Study of the Epidemiology of Pancreatic Cancer: A Brief Report

Abstract

Objective 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.Methods 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.Results 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. ConclusionsThe 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.

Rural–urban residence and cancer survival in high‐income countries: A systematic review

“…Of the 3 studies examining rural and urban differences in survival from non‐Hodgkin lymphoma, a Canadian study and an Australian study observed no significant differences in survival between rural and urban regions, whereas a study from France reported that rural patients had a 2‐fold higher risk of death compared with urban cases. Lastly, an Australian study reported similar survival experience from pancreatic cancer among patients living in rural and urban regions, whereas 2 studies from the United States and Canada found that rural residents with pancreatic cancer have worse overall survival than those living in urban areas, although the sample size in the United States study was small (245 cases).…”

“…Seventeen studies were conducted in Australia, 16 in the United States, 6 in Europe, 4 in Canada, and 2 in New Zealand . These studies investigated several neoplasms including female breast, male breast, cervix, colorectum, endometrium, esophagus and stomach, liver (intrahepatic cholangiocarcinoma), lung, melanoma, neuroendocrine tumours, non‐Hodgkin lymphoma, ovary, pancreas, prostate, and selected groups of cancers . Most studies used only population‐based cancer registry data, while others used data from a range of sources including hospitals, academic medical centers, or treatment services or registries; others used population‐based cancer registries linked with public and private hospitals and treatment datasets .…”

“…Others defined rural/urban residence based on population size or density, local government area, or distance from treatment centers . Some studies defined location based on the patients’ medical service study area, address, residential postal code, or main income sources for the municipality . One Australian study simply compared metropolitan and other residence, and one study did not provide detailed information on how “rural” and “urban” were defined …”

“…1). Of these, 15 studies that adjusted for at least one mediator did not report any significant differences in survival by area of residence, whereas the remaining studies found evidence of association between rural and urban residence and cancer survival . Of 5 studies that observed inequalities in survival and reported the results with and without including the mediators in the models, 3 suggested that treatment partially explained rural/urban differences in survival from colorectal, lung, and breast cancer .…”

Cancer survival in Qidong between 1972 and 2011: A population-based analysis

“…There have been numerous reports on cancer survival revealing improvements through various therapies, derived from hospital-based datasets (1)(2)(3)(4). However, there are few reports on the general efficiency of cancer health services derived from long-term population-based cancer registration systems (5)(6)(7)(8)(9)(10).…”