A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs

Abstract

PurposeThe purpose of this study was to assess the overall burden of pancreatic cancer in Europe, with a focus on survival time in a real-world setting, and the overall healthy life lost to the disease.MethodsReal-world data were retrieved from peer-reviewed, observational studies identified by an electronic search. We performed two de novo analyses: a proportional shortfall analysis to quantify the proportion of healthy life lost to pancreatic cancer and an estimation of the aggregate life-years lost annually in Europe.ResultsNinety-one studies were included. The median, age-standardised incidence of pancreatic cancer per 100,000 was 7.6 in men and 4.9 in women. Overall median survival from diagnosis was 4.6 months; median survival was 2.8–5.7 months in patients with metastatic disease. The proportional shortfall analysis showed that pancreatic cancer results in a 98 % loss of healthy life, with a life expectancy at diagnosis of 4.6 months compared to 15.1 years for an age-matched healthy population. Annually, 610,000–915,000 quality-adjusted life-years (QALYs) are lost to pancreatic cancer in Europe. Patients had significantly lower scores on validated health-related quality of life instruments versus population norms.ConclusionsTo the best of our knowledge, this is the first study to systematically review real-world overall survival and patient outcomes of pancreatic cancer patients in Europe outside the context of clinical trials. Our findings confirm the poor prognosis and short survival reported by national studies. Pancreatic cancer is a substantial burden in Europe, with nearly a million aggregate life-years lost annually and almost complete loss of healthy life in affected individuals.Electronic supplementary materialThe online version of this article (doi:10.1007/s12029-015-9724-1) contains supplementary material, which is available to authorized users.

Epidemiology of pancreatic cancer

“…Survival rates of pancreatic cancer in population are affected by many factors, such as the type of cancer, the staging at the time of diagnosis, serum albumin level, and tumor size, treatment modality, availability and differences in health care systems, and other factors including age, sex, overall health, lifestyle[23,37,41-50]. Besides, pancreatic cancer survival rates could be influenced by factors such as the validity of cancer registry, exhaustiveness and quality of registration data, completeness of follow-up[22,51].…”

Familial Pancreatic Cancer

“…In general, the costs for patients with pancreatic cancer involve diagnosis, treatment, hospitalization, and productivity loss [104,105,106]. These high costs need to be reduced and be subject to economic evaluation [107,108].…”

Current therapeutic strategies for advanced pancreatic cancer: A review for clinicians

“…Outside the context of clinical trials [67] , median OS in patients with metastatic PC is 2.8-5.7 mo. However, despite the aggressiveness of this disease, in recent years the better results obtained with first-line chemotherapy have allowed a wider use of secondline treatments.…”