A recent population time trend analysis conducted from 2001 to 2018 has confirmed the growing incidence of pancreatic cancer in young women in the U.S. Based on age and sex-specific data from the National Program of Cancer Registries database, the analysis revealed a significant increase in age-adjusted incidence rates (aIRs) of pancreatic cancer among both women (average annual percentage change [AAPC] = 1.27%) and men (AAPC = 1.14%), without a notable difference between the genders.
The study further focused on analyzing different age groups and discovered a striking disparity in the rate of increase among younger adults. Specifically, women in this age range experienced a considerably higher surge in aIR (AAPC = 2.36%) compared to men (AAPC = 0.62%). These nonparallel trends indicated a substantially higher rate of pancreatic cancer diagnoses in women. The analysis also identified several contributing factors to this disparity, including rising aIR in Black patients (AAPC = 2.23%), adenocarcinoma histology (AAPC = 0.89%), and tumors located in the head of the pancreas (AAPC = 1.64%). Interestingly, pancreatic cancer mortality rates remained unchanged in women while decreasing in men, highlighting a discrepancy in the impact of the disease on the respective genders.
These findings emphasize the urgency of further research to better understand the underlying factors contributing to the increased incidence of pancreatic cancer in young women and its implications for prevention and treatment strategies.
The rise of pancreatic cancer as well as other GI cancers in young patients is palpable in our clinical practice. Although the cause is likely multifactorial, young patients and their evaluating providers may potentially under-recognize symptoms as early signs of malignancy. Basic diagnostic tests, such as labs and ultrasound, can easily miss rare neoplasms. Nonspecific, refractory abdominal pain, weight loss, poor appetite or nausea should be thoroughly evaluated with contrast-enhanced imaging. Family history can be informative to identify patients at particularly high risk but is usually negative.
It is critical that all patients with a new diagnosis of pancreatic cancer be evaluated in a comprehensive, multidisciplinary fashion by an experienced team including the surgeon, medical oncologist, radiation oncologist, radiologist, pathologist, dietitian and genetic counselor. At Atlanta Liver and Pancreas Surgical Specialists, we are privileged to be able to help patients understand their surgical options. as well as other treatments upon initial diagnosis, and to care for many of them before and after their major pancreatic cancer surgery.
- Abboud Y, et al. Gastroenterology. 2023;164:978-989.