Trends in pancreatic cancer mortality in Europe, 1955–1989

Abstract

Trends in death certification rates from pancreatic cancer over the period 1955-1989 were analyzed for 25 European countries (excluding the former Soviet Union and a few smaller countries). In 1985-1989, rates for males ranged between 5.3/100,000 (age-standardized world population) in Spain and 10.3/100,000 in Hungary and Czechoslovakia. Other high-mortality areas were located in Northern Europe (Finland, Iceland, Ireland, Denmark) and Central Europe (Austria, Poland, Germany), whilst mortality was lower in Southern Europe (Portugal, Greece). Between 1955 and 1989, mortality rates increased in all the countries considered, the change ranging between 6% in Scotland and 279% in Spain; the rises were higher in the Mediterranean and Eastern European countries than in Northern Europe. Among females, Nordic countries such as Iceland, Sweden and Denmark had the highest mortality rates in 1985-1989 (over 6/100,000) and, as for males, Southern Europe (Spain, Portugal, Greece) appeared as a low-mortality area (around 3/100,000). During the 1955-1989 period, upward trends were observed in all the countries studied, with the highest increase in Greece, Italy, Bulgaria, Poland and Spain. A negative correlation was observed between the percent change in mortality rates between 1955-1959 and 1985-1989 and the rate in 1955-1959 among both males (r = -0.95, p < 0.001) and females (r = -0.81, p < 0.001). Thus, a systematic levelling of rates was observed in most countries, with the exception of the UK and some Nordic countries, whose rates were already high in the late 1950s. Tobacco smoking and dietary factors could account for some of the generalized upward trends. Improved diagnostic and death certification of the disease might also partially explain the observed figures.

Cigarette smoke-induced pancreatic damage—experimental data

“…This correlation between cigarette smoking and pancreatic cancer has been observed in many epidemiological studies, thus confirming cigarette smoking as the only avoidable risk factor for the development of pancreatic cancer subsequently allowing the speculation that an instant smoking cessation could lead to a 15% reduction of pancreatic cancer cases [3][4][5].…”

Comprehensive Analysis of Matrix Metalloproteinase and Tissue Inhibitor Expression in Pancreatic Cancer

“…Pancreatic cancer is a major cause of cancer death in North America and Europe, and its incidence has appeared to increase dramatically in the last 70 years (1)(2)(3)(4). Disappointingly, the 5-year survival rate of Ͻ5% has shown little improvement in the last 30 years (2,5,6).…”

A double-blind placebo-controlled, randomised study comparing gemcitabine and marimastat with gemcitabine and placebo as first line therapy in patients with advanced pancreatic cancer

“…There are an estimated 26 000 deaths in the US and 50 000 deaths per year in Europe (excluding the former USSR) (Fernandez et al, 1994;Wingo et al, 1995). The overall 5 year survival rate (5YSR) for patients with pancreatic cancer ranges from 51% to less than 5% even in the best prognosis patients and there has been little improvement in survival in the last 20 years (Bramhall et al, 1995).…”