National trends in hospital morbidity and mortality from pancreatic cancer in Ecuador, 2008-2023.

BACKGROUND

Pancreatic cancer is one of the most lethal malignancies and represents a growing public health challenge. In Ecuador, national evidence on hospital-based morbidity and mortality remains scarce, limiting the characterization of disease burden and the development of cancer surveillance and care strategies.

OBJECTIVE

To assess national trends in hospital morbidity and mortality from pancreatic cancer in Ecuador from 2008 to 2023.

METHODS

This retrospective descriptive time-series study used secondary administrative data from the National Institute of Statistics and Census of Ecuador. Hospital discharge and death certificate-based mortality records coded as C25 according to ICD-10 were included. Crude and age-standardized hospital morbidity and mortality rates were calculated annually per 100,000 inhabitants. Age-standardized rates were estimated by the direct method using the WHO World Standard Population. Temporal trends were assessed using log-linear regression and annual percent change estimates with 95% confidence intervals.

RESULTS

Between 2008 and 2023, 10,818 hospital discharge records and 6573 deaths due to pancreatic cancer were identified. Men accounted for 50.5% of hospital discharge records, and the most frequent age group was 60-69 years. The crude hospital morbidity rate increased from 2.31 to 7.50 per 100,000 inhabitants, while the age-standardized rate increased from 3.18 to 7.90 per 100,000 inhabitants. This increase was statistically significant for both crude rates (annual percent change: 8.56%; 95% CI: 6.95-10.19; p < 0.001) and age-standardized rates (annual percent change: 6.63%; 95% CI: 5.02-8.26; p < 0.001). Sex-specific age-standardized hospital morbidity rates increased in both men and women and were broadly comparable in 2023. Crude mortality increased from 2.06 to 2.89 per 100,000 inhabitants. In contrast, age-standardized mortality remained relatively stable, changing from 2.90 to 2.95 per 100,000 inhabitants, with no statistically significant annual change (annual percent change: 0.46%; 95% CI: -0.58-1.51; p = 0.359). Hospital discharge records were concentrated among urban residents and in the Sierra and Coast regions.

CONCLUSIONS

Hospital morbidity from pancreatic cancer increased significantly in Ecuador between 2008 and 2023, whereas age-standardized mortality showed no significant temporal change. These findings indicate a growing hospital burden and emphasize the need to strengthen cancer surveillance systems, improve mortality certification, enhance timely diagnostic capacity, and reduce inequities in access to specialized oncologic care across Ecuador.