The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
Pourshams A, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY . 2019;...
Published in: | The Lancet Gastroenterology & Hepatology |
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Format: | Article in Journal/Newspaper |
Language: | English |
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Elsevier Inc
2019
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Online Access: | https://pub.uni-bielefeld.de/record/2939167 |
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Pourshams A, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY . 2019;4(12):934-947. Background Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51.9%) were in males. The age-standardised incidence rate was 5.0 (4.9-5.1) per 100 000 person-years in 1990 and increased to 5.7 (5.6-5.8) per 100 000 person-years in 2017. There was a 2.3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2.1 times increase in DALYs due to pancreatic cancer, increasing from 4.4 million (4.3-4.5) in 1990 to 9.1 million (8.9-9.3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17.4 [15.8-19.0] per 100 000 person-years) and Uruguay (12.1 [10.9-13.5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1.9 [1.5-2.3] per 100 000 person-years) had the lowest rate in 2017, and Sao Tome and Principe (1.3 [1.1-1.5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21.1% [18.8-23.7]), high fasting plasma glucose (8.9% [2.1-19.4]), and high body-mass index (6.2% [2.5-11.4]) in 2017. Interpretation Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. |
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Article in Journal/Newspaper |
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Pourshams, Akram Sepanlou, Sadaf G. Ikuta, Kevin S. Bisignano, Catherine Safiri, Saeid Roshandel, Gholamreza Sharif, Mehdi Khatibian, Morteza Fitzmaurice, Christina Nixon, Molly R. Abbasi, Nooshin Afarideh, Mohsen Ahmadian, Elham Akinyemiju, Tomi Alahdab, Fares Alam, Tahiya Alipour, Vahid Allen, Christine A. Anber, Nahla Hamed Ansari-Moghaddam, Alireza Arabloo, Jalal Badawi, Alaa Bagherzadeh, Mojtaba Belayneh, Yaschilal Muche Biadgo, Belete Bijani, Ali Biondi, Antonio Bjorge, Tone Borzi, Antonio M. Bosetti, Cristina Briko, Andrey Nikolaevich Briko, Nikolay Ivanovich Carreras, Giulia Carvalho, Felix Choi, Jee-Young J. Dinh-Toi Chu, Dinh-Toi Chu Anh Kim Dang, Anh Kim Dang Daryani, Ahmad Davitoiu, Dragos Virgil Demoz, Gebre Teklemariam Desai, Rupak Dey, Subhojit Hoa Thi Do, Hoa Thi Do Huyen Phuc Do, Huyen Phuc Do Eftekhari, Aziz Esteghamati, Alireza Farzadfar, Farshad Fernandes, Eduarda Filip, Irina Fischer, Florian Foroutan, Masoud Gad, Mohamed M. Gallus, Silvano Geta, Birhanu Gorini, Giuseppe Hafezi-Nejad, Nima Harvey, James D. Hasankhani, Milad Hasanzadeh, Amir Hassanipour, Soheil Hay, Simon, I Hidru, Hagos D. Chi Linh Hoang, Chi Linh Hoang Hostiuc, Sorin Househ, Mowafa Ilesanmi, Olayinka Stephen Ilic, Milena D. Irvani, Seyed Sina Naghibi Balalami, Nader Jafari James, Spencer L. Joukar, Farahnaz Kasaeian, Amir Kassa, Tesfaye Dessale Kengne, Andre Pascal Khalilov, Rovshan Khan, Ejaz Ahmad Khater, Amir Shadmani, Fatemeh Khosravi Kocarnik, Jonathan M. Komaki, Hamidreza Koyanagi, Ai Kumar, Vivek La Vecchia, Carlo Lopukhov, Platon D. Manafi, Farzad Manafi, Navid Manda, Ana-Laura Mansour-Ghanaei, Fariborz Mehta, Dhruv Mehta, Varshil Meier, Toni Meles, Hagazi Gebre Mengistu, Getnet Miazgowski, Tomasz Mohamadnejad, Mehdi Mohammadian-Hafshejani, Abdollah Mohammadoo-Khorasani, Milad Mohammed, Shafiu Mohebi, Farnam Mokdad, Ali H. Monasta, Lorenzo Moossavi, Maryam Moradzadeh, Rahmatollah Naik, Gurudatta Negoi, Ionut Cuong Tat Nguyen, Cuong Tat Nguyen Long Hoang Nguyen, Long Hoang Nguyen Trang Huyen Nguyen, Trang Huyen Nguyen Olagunju, Andrew T. Olagunju, Tinuke O. Pennini, Alyssa Rabiee, Mohammad Rabiee, Navid Radfar, Amir Rahimi, Mahdi Rath, Goura Kishor Rawaf, David Laith Rawaf, Salman Reiner, Robert C., Jr. Rezaei, Nima Rezapour, Aziz Saad, Anas M. Saadatagah, Seyedmohammad Sahebkar, Amirhossein Salimzadeh, Hamideh Samy, Abdallah M. Sanabria, Juan Sarveazad, Arash Sawhney, Monika Sekerija, Mario Shabalkin, Pavel Shaikh, Masood Ali Sharma, Rajesh Sheikhbahaei, Sara Shirkoohi, Reza Malleshappa, Sudeep K. Siddappa Sisay, Mekonnen Soreide, Kjetil Soshnikov, Sergey Sotoudehmanesh, Rasoul Starodubov, Vladimir, I Subart, Michelle L. Tabares-Seisdedos, Rafael Tadesse, Degena Bahray Bahrey Traini, Eugenio Bach Xuan Tran, Bach Xuan Tran Khanh Bao Tran, Khanh Bao Tran Ullah, Irfan Vacante, Marco Vahedian-Azimi, Amir Varavikova, Elena Westerman, Ronny Wondafrash, Dawit Zewdu Xu, Rixing Yonemoto, Naohiro Zadnik, Vesna Zhang, Zhi-Jiang Malekzadeh, Reza Naghavi, Mohsen |
spellingShingle |
Pourshams, Akram Sepanlou, Sadaf G. Ikuta, Kevin S. Bisignano, Catherine Safiri, Saeid Roshandel, Gholamreza Sharif, Mehdi Khatibian, Morteza Fitzmaurice, Christina Nixon, Molly R. Abbasi, Nooshin Afarideh, Mohsen Ahmadian, Elham Akinyemiju, Tomi Alahdab, Fares Alam, Tahiya Alipour, Vahid Allen, Christine A. Anber, Nahla Hamed Ansari-Moghaddam, Alireza Arabloo, Jalal Badawi, Alaa Bagherzadeh, Mojtaba Belayneh, Yaschilal Muche Biadgo, Belete Bijani, Ali Biondi, Antonio Bjorge, Tone Borzi, Antonio M. Bosetti, Cristina Briko, Andrey Nikolaevich Briko, Nikolay Ivanovich Carreras, Giulia Carvalho, Felix Choi, Jee-Young J. Dinh-Toi Chu, Dinh-Toi Chu Anh Kim Dang, Anh Kim Dang Daryani, Ahmad Davitoiu, Dragos Virgil Demoz, Gebre Teklemariam Desai, Rupak Dey, Subhojit Hoa Thi Do, Hoa Thi Do Huyen Phuc Do, Huyen Phuc Do Eftekhari, Aziz Esteghamati, Alireza Farzadfar, Farshad Fernandes, Eduarda Filip, Irina Fischer, Florian Foroutan, Masoud Gad, Mohamed M. Gallus, Silvano Geta, Birhanu Gorini, Giuseppe Hafezi-Nejad, Nima Harvey, James D. Hasankhani, Milad Hasanzadeh, Amir Hassanipour, Soheil Hay, Simon, I Hidru, Hagos D. Chi Linh Hoang, Chi Linh Hoang Hostiuc, Sorin Househ, Mowafa Ilesanmi, Olayinka Stephen Ilic, Milena D. Irvani, Seyed Sina Naghibi Balalami, Nader Jafari James, Spencer L. Joukar, Farahnaz Kasaeian, Amir Kassa, Tesfaye Dessale Kengne, Andre Pascal Khalilov, Rovshan Khan, Ejaz Ahmad Khater, Amir Shadmani, Fatemeh Khosravi Kocarnik, Jonathan M. Komaki, Hamidreza Koyanagi, Ai Kumar, Vivek La Vecchia, Carlo Lopukhov, Platon D. Manafi, Farzad Manafi, Navid Manda, Ana-Laura Mansour-Ghanaei, Fariborz Mehta, Dhruv Mehta, Varshil Meier, Toni Meles, Hagazi Gebre Mengistu, Getnet Miazgowski, Tomasz Mohamadnejad, Mehdi Mohammadian-Hafshejani, Abdollah Mohammadoo-Khorasani, Milad Mohammed, Shafiu Mohebi, Farnam Mokdad, Ali H. Monasta, Lorenzo Moossavi, Maryam Moradzadeh, Rahmatollah Naik, Gurudatta Negoi, Ionut Cuong Tat Nguyen, Cuong Tat Nguyen Long Hoang Nguyen, Long Hoang Nguyen Trang Huyen Nguyen, Trang Huyen Nguyen Olagunju, Andrew T. Olagunju, Tinuke O. Pennini, Alyssa Rabiee, Mohammad Rabiee, Navid Radfar, Amir Rahimi, Mahdi Rath, Goura Kishor Rawaf, David Laith Rawaf, Salman Reiner, Robert C., Jr. Rezaei, Nima Rezapour, Aziz Saad, Anas M. Saadatagah, Seyedmohammad Sahebkar, Amirhossein Salimzadeh, Hamideh Samy, Abdallah M. Sanabria, Juan Sarveazad, Arash Sawhney, Monika Sekerija, Mario Shabalkin, Pavel Shaikh, Masood Ali Sharma, Rajesh Sheikhbahaei, Sara Shirkoohi, Reza Malleshappa, Sudeep K. Siddappa Sisay, Mekonnen Soreide, Kjetil Soshnikov, Sergey Sotoudehmanesh, Rasoul Starodubov, Vladimir, I Subart, Michelle L. Tabares-Seisdedos, Rafael Tadesse, Degena Bahray Bahrey Traini, Eugenio Bach Xuan Tran, Bach Xuan Tran Khanh Bao Tran, Khanh Bao Tran Ullah, Irfan Vacante, Marco Vahedian-Azimi, Amir Varavikova, Elena Westerman, Ronny Wondafrash, Dawit Zewdu Xu, Rixing Yonemoto, Naohiro Zadnik, Vesna Zhang, Zhi-Jiang Malekzadeh, Reza Naghavi, Mohsen The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
author_facet |
Pourshams, Akram Sepanlou, Sadaf G. Ikuta, Kevin S. Bisignano, Catherine Safiri, Saeid Roshandel, Gholamreza Sharif, Mehdi Khatibian, Morteza Fitzmaurice, Christina Nixon, Molly R. Abbasi, Nooshin Afarideh, Mohsen Ahmadian, Elham Akinyemiju, Tomi Alahdab, Fares Alam, Tahiya Alipour, Vahid Allen, Christine A. Anber, Nahla Hamed Ansari-Moghaddam, Alireza Arabloo, Jalal Badawi, Alaa Bagherzadeh, Mojtaba Belayneh, Yaschilal Muche Biadgo, Belete Bijani, Ali Biondi, Antonio Bjorge, Tone Borzi, Antonio M. Bosetti, Cristina Briko, Andrey Nikolaevich Briko, Nikolay Ivanovich Carreras, Giulia Carvalho, Felix Choi, Jee-Young J. Dinh-Toi Chu, Dinh-Toi Chu Anh Kim Dang, Anh Kim Dang Daryani, Ahmad Davitoiu, Dragos Virgil Demoz, Gebre Teklemariam Desai, Rupak Dey, Subhojit Hoa Thi Do, Hoa Thi Do Huyen Phuc Do, Huyen Phuc Do Eftekhari, Aziz Esteghamati, Alireza Farzadfar, Farshad Fernandes, Eduarda Filip, Irina Fischer, Florian Foroutan, Masoud Gad, Mohamed M. Gallus, Silvano Geta, Birhanu Gorini, Giuseppe Hafezi-Nejad, Nima Harvey, James D. Hasankhani, Milad Hasanzadeh, Amir Hassanipour, Soheil Hay, Simon, I Hidru, Hagos D. Chi Linh Hoang, Chi Linh Hoang Hostiuc, Sorin Househ, Mowafa Ilesanmi, Olayinka Stephen Ilic, Milena D. Irvani, Seyed Sina Naghibi Balalami, Nader Jafari James, Spencer L. Joukar, Farahnaz Kasaeian, Amir Kassa, Tesfaye Dessale Kengne, Andre Pascal Khalilov, Rovshan Khan, Ejaz Ahmad Khater, Amir Shadmani, Fatemeh Khosravi Kocarnik, Jonathan M. Komaki, Hamidreza Koyanagi, Ai Kumar, Vivek La Vecchia, Carlo Lopukhov, Platon D. Manafi, Farzad Manafi, Navid Manda, Ana-Laura Mansour-Ghanaei, Fariborz Mehta, Dhruv Mehta, Varshil Meier, Toni Meles, Hagazi Gebre Mengistu, Getnet Miazgowski, Tomasz Mohamadnejad, Mehdi Mohammadian-Hafshejani, Abdollah Mohammadoo-Khorasani, Milad Mohammed, Shafiu Mohebi, Farnam Mokdad, Ali H. Monasta, Lorenzo Moossavi, Maryam Moradzadeh, Rahmatollah Naik, Gurudatta Negoi, Ionut Cuong Tat Nguyen, Cuong Tat Nguyen Long Hoang Nguyen, Long Hoang Nguyen Trang Huyen Nguyen, Trang Huyen Nguyen Olagunju, Andrew T. Olagunju, Tinuke O. Pennini, Alyssa Rabiee, Mohammad Rabiee, Navid Radfar, Amir Rahimi, Mahdi Rath, Goura Kishor Rawaf, David Laith Rawaf, Salman Reiner, Robert C., Jr. Rezaei, Nima Rezapour, Aziz Saad, Anas M. Saadatagah, Seyedmohammad Sahebkar, Amirhossein Salimzadeh, Hamideh Samy, Abdallah M. Sanabria, Juan Sarveazad, Arash Sawhney, Monika Sekerija, Mario Shabalkin, Pavel Shaikh, Masood Ali Sharma, Rajesh Sheikhbahaei, Sara Shirkoohi, Reza Malleshappa, Sudeep K. Siddappa Sisay, Mekonnen Soreide, Kjetil Soshnikov, Sergey Sotoudehmanesh, Rasoul Starodubov, Vladimir, I Subart, Michelle L. Tabares-Seisdedos, Rafael Tadesse, Degena Bahray Bahrey Traini, Eugenio Bach Xuan Tran, Bach Xuan Tran Khanh Bao Tran, Khanh Bao Tran Ullah, Irfan Vacante, Marco Vahedian-Azimi, Amir Varavikova, Elena Westerman, Ronny Wondafrash, Dawit Zewdu Xu, Rixing Yonemoto, Naohiro Zadnik, Vesna Zhang, Zhi-Jiang Malekzadeh, Reza Naghavi, Mohsen |
author_sort |
Pourshams, Akram |
title |
The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
title_short |
The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
title_full |
The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
title_fullStr |
The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
title_full_unstemmed |
The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 |
title_sort |
global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017 |
publisher |
Elsevier Inc |
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2019 |
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https://pub.uni-bielefeld.de/record/2939167 |
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ENVELOPE(141.975,141.975,60.184,60.184) |
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Greenland Uis Uruguay |
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Greenland Uis Uruguay |
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Greenland |
genre_facet |
Greenland |
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https://doi.org/10.1016/S2468-1253(19)30347-4 |
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The Lancet Gastroenterology & Hepatology |
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ftubbiepub:oai:pub.uni-bielefeld.de:2939167 2023-05-15T16:30:45+02:00 The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 Pourshams, Akram Sepanlou, Sadaf G. Ikuta, Kevin S. Bisignano, Catherine Safiri, Saeid Roshandel, Gholamreza Sharif, Mehdi Khatibian, Morteza Fitzmaurice, Christina Nixon, Molly R. Abbasi, Nooshin Afarideh, Mohsen Ahmadian, Elham Akinyemiju, Tomi Alahdab, Fares Alam, Tahiya Alipour, Vahid Allen, Christine A. Anber, Nahla Hamed Ansari-Moghaddam, Alireza Arabloo, Jalal Badawi, Alaa Bagherzadeh, Mojtaba Belayneh, Yaschilal Muche Biadgo, Belete Bijani, Ali Biondi, Antonio Bjorge, Tone Borzi, Antonio M. Bosetti, Cristina Briko, Andrey Nikolaevich Briko, Nikolay Ivanovich Carreras, Giulia Carvalho, Felix Choi, Jee-Young J. Dinh-Toi Chu, Dinh-Toi Chu Anh Kim Dang, Anh Kim Dang Daryani, Ahmad Davitoiu, Dragos Virgil Demoz, Gebre Teklemariam Desai, Rupak Dey, Subhojit Hoa Thi Do, Hoa Thi Do Huyen Phuc Do, Huyen Phuc Do Eftekhari, Aziz Esteghamati, Alireza Farzadfar, Farshad Fernandes, Eduarda Filip, Irina Fischer, Florian Foroutan, Masoud Gad, Mohamed M. Gallus, Silvano Geta, Birhanu Gorini, Giuseppe Hafezi-Nejad, Nima Harvey, James D. Hasankhani, Milad Hasanzadeh, Amir Hassanipour, Soheil Hay, Simon, I Hidru, Hagos D. Chi Linh Hoang, Chi Linh Hoang Hostiuc, Sorin Househ, Mowafa Ilesanmi, Olayinka Stephen Ilic, Milena D. Irvani, Seyed Sina Naghibi Balalami, Nader Jafari James, Spencer L. Joukar, Farahnaz Kasaeian, Amir Kassa, Tesfaye Dessale Kengne, Andre Pascal Khalilov, Rovshan Khan, Ejaz Ahmad Khater, Amir Shadmani, Fatemeh Khosravi Kocarnik, Jonathan M. Komaki, Hamidreza Koyanagi, Ai Kumar, Vivek La Vecchia, Carlo Lopukhov, Platon D. Manafi, Farzad Manafi, Navid Manda, Ana-Laura Mansour-Ghanaei, Fariborz Mehta, Dhruv Mehta, Varshil Meier, Toni Meles, Hagazi Gebre Mengistu, Getnet Miazgowski, Tomasz Mohamadnejad, Mehdi Mohammadian-Hafshejani, Abdollah Mohammadoo-Khorasani, Milad Mohammed, Shafiu Mohebi, Farnam Mokdad, Ali H. Monasta, Lorenzo Moossavi, Maryam Moradzadeh, Rahmatollah Naik, Gurudatta Negoi, Ionut Cuong Tat Nguyen, Cuong Tat Nguyen Long Hoang Nguyen, Long Hoang Nguyen Trang Huyen Nguyen, Trang Huyen Nguyen Olagunju, Andrew T. Olagunju, Tinuke O. Pennini, Alyssa Rabiee, Mohammad Rabiee, Navid Radfar, Amir Rahimi, Mahdi Rath, Goura Kishor Rawaf, David Laith Rawaf, Salman Reiner, Robert C., Jr. Rezaei, Nima Rezapour, Aziz Saad, Anas M. Saadatagah, Seyedmohammad Sahebkar, Amirhossein Salimzadeh, Hamideh Samy, Abdallah M. Sanabria, Juan Sarveazad, Arash Sawhney, Monika Sekerija, Mario Shabalkin, Pavel Shaikh, Masood Ali Sharma, Rajesh Sheikhbahaei, Sara Shirkoohi, Reza Malleshappa, Sudeep K. Siddappa Sisay, Mekonnen Soreide, Kjetil Soshnikov, Sergey Sotoudehmanesh, Rasoul Starodubov, Vladimir, I Subart, Michelle L. Tabares-Seisdedos, Rafael Tadesse, Degena Bahray Bahrey Traini, Eugenio Bach Xuan Tran, Bach Xuan Tran Khanh Bao Tran, Khanh Bao Tran Ullah, Irfan Vacante, Marco Vahedian-Azimi, Amir Varavikova, Elena Westerman, Ronny Wondafrash, Dawit Zewdu Xu, Rixing Yonemoto, Naohiro Zadnik, Vesna Zhang, Zhi-Jiang Malekzadeh, Reza Naghavi, Mohsen 2019 https://pub.uni-bielefeld.de/record/2939167 eng eng Elsevier Inc info:eu-repo/semantics/altIdentifier/doi/10.1016/S2468-1253(19)30347-4 info:eu-repo/semantics/altIdentifier/issn/2468-1253 info:eu-repo/semantics/altIdentifier/wos/000495074600020 info:eu-repo/semantics/altIdentifier/pmid/31648972 https://pub.uni-bielefeld.de/record/2939167 info:eu-repo/semantics/closedAccess http://purl.org/coar/resource_type/c_6501 info:eu-repo/semantics/article doc-type:article text 2019 ftubbiepub https://doi.org/10.1016/S2468-1253(19)30347-4 2022-02-08T22:35:47Z Pourshams A, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY . 2019;4(12):934-947. Background Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51.9%) were in males. The age-standardised incidence rate was 5.0 (4.9-5.1) per 100 000 person-years in 1990 and increased to 5.7 (5.6-5.8) per 100 000 person-years in 2017. There was a 2.3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2.1 times increase in DALYs due to pancreatic cancer, increasing from 4.4 million (4.3-4.5) in 1990 to 9.1 million (8.9-9.3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17.4 [15.8-19.0] per 100 000 person-years) and Uruguay (12.1 [10.9-13.5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1.9 [1.5-2.3] per 100 000 person-years) had the lowest rate in 2017, and Sao Tome and Principe (1.3 [1.1-1.5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21.1% [18.8-23.7]), high fasting plasma glucose (8.9% [2.1-19.4]), and high body-mass index (6.2% [2.5-11.4]) in 2017. Interpretation Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. Article in Journal/Newspaper Greenland PUB - Publications at Bielefeld University Greenland Uis ENVELOPE(141.975,141.975,60.184,60.184) Uruguay The Lancet Gastroenterology & Hepatology 4 12 934 947 |