ANZ journal of surgery · 2026
Temporal Trends in Pancreatic Cancer in New South Wales, Australia: A Longitudinal Population-Based Study of Incidence, Surgery and Survival.
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Mok Joshua, Close Jacqueline, Gandy Robert, Harvey Lara
Аннотация
INTRODUCTION: The incidence of pancreatic adenocarcinoma is increasing, as is the proportion of patients undergoing pancreatectomy. This study aimed to identify temporal trends in incidence, survival and pancreatectomy uptake in New South Wales (NSW), in patients aged 50 years and older diagnosed with pancreatic and periampullary cancer.
METHODS: This study linked NSW Hospitalisation, Death, and Cancer Registry data. Analysis included patients aged 50 years and older diagnosed or admitted for pancreatic or periampullary cancer (2009-2018). We analysed temporal trends in incidence and age-standardised rates of pancreatic cancer, pancreatectomy rates, and 1-, 3- and 5-year post-diagnosis survival.
RESULTS: Thirteen thousand five hundred and sixty patients were identified, with annual cases increasing from 1148 to 1591. Age-standardised pancreatic cancer rates increased from 50.3/100 000 to 56.3/100 000 population, an annual increase from 2009 to 2018 of 1.5% (95% CI 1.0-2.0). From 2009 to 2018, one- (27.7% vs. 39.7%) and three- (13.8% vs. 20.9%) year survival improved, and an increased proportion of patients underwent resection (14.5% to 21.4%). Five-year survival similarly improved (11.6% vs. 19.0%) between 2009 and 2016. Pancreaticoduodenectomy rates decreased, and non-pancreaticoduodenectomy resection rates increased. An increased proportion of pancreatectomies were conducted in high volume centres (≥ 16 pancreatectomies). Diagnosis in a later year improved survival in both the whole, and the surgical cohorts at all endpoints.
CONCLUSIONS: In NSW, rates of pancreatic and periampullary cancer in people aged 50 years and older have risen. Despite remaining a disease of high mortality, survival has improved over a 10-year period, and resection is increasingly utilised.
METHODS: This study linked NSW Hospitalisation, Death, and Cancer Registry data. Analysis included patients aged 50 years and older diagnosed or admitted for pancreatic or periampullary cancer (2009-2018). We analysed temporal trends in incidence and age-standardised rates of pancreatic cancer, pancreatectomy rates, and 1-, 3- and 5-year post-diagnosis survival.
RESULTS: Thirteen thousand five hundred and sixty patients were identified, with annual cases increasing from 1148 to 1591. Age-standardised pancreatic cancer rates increased from 50.3/100 000 to 56.3/100 000 population, an annual increase from 2009 to 2018 of 1.5% (95% CI 1.0-2.0). From 2009 to 2018, one- (27.7% vs. 39.7%) and three- (13.8% vs. 20.9%) year survival improved, and an increased proportion of patients underwent resection (14.5% to 21.4%). Five-year survival similarly improved (11.6% vs. 19.0%) between 2009 and 2016. Pancreaticoduodenectomy rates decreased, and non-pancreaticoduodenectomy resection rates increased. An increased proportion of pancreatectomies were conducted in high volume centres (≥ 16 pancreatectomies). Diagnosis in a later year improved survival in both the whole, and the surgical cohorts at all endpoints.
CONCLUSIONS: In NSW, rates of pancreatic and periampullary cancer in people aged 50 years and older have risen. Despite remaining a disease of high mortality, survival has improved over a 10-year period, and resection is increasingly utilised.