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Epidemiology

Pancreatic cancer survival by stage and age in seven high-income countries (ICBP SURVMARK-2): a population-based study

British Journal of Cancer volume 126, pages 1774–1782 (2022)Cite this article

Subjects

Abstract

Background

The global burden of pancreatic cancer has steadily increased, while the prognosis after pancreatic cancer diagnosis remains poor. This study aims to compare the stage- and age-specific pancreatic cancer net survival (NS) for seven high-income countries: Australia, Canada, Denmark, Ireland, New Zealand, Norway, and United Kingdom.

Methods

The study included over 35,000 pancreatic cancer cases diagnosed during 2012–2014, followed through 31 December 2015. The stage- and age-specific NS were calculated using the Pohar-Perme estimator.

Results

Pancreatic cancer survival estimates were low across all 7 countries, with 1-year NS ranging from 21.1% in New Zealand to 30.9% in Australia, and 3-year NS from 6.6% in the UK to 10.9% in Australia. Most pancreatic cancers were diagnosed with distant stage, ranging from 53.9% in Ireland to 83.3% in New Zealand. While survival differences were evident between countries across all stage categories at one year after diagnosis, this survival advantage diminished, particularly in cases with distant stage.

Conclusion

This study demonstrated the importance of stage and age at diagnosis in pancreatic cancer survival. Although progress has been made in improving pancreatic cancer prognosis, the disease is highly fatal and will remain so without major breakthroughs in the early diagnosis and management.

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Fig. 1: Age-standardised 1- and 3-year net survival (all ages combined) with 95% confidence interval among cases diagnosed with pancreatic cancer by country, 2012–2014.
Fig. 2: Age-standardised 1- and 3-year net survival (all ages combined) with 95% confidence interval among cases diagnosed with pancreatic cancer by SEER stage and country, 2012–2014.
Fig. 3: Age-specific 1-year and 3-year net survival among pancreatic cancer cases by stage and country, 2012–2014.

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Data availability

This study is based on cancer registry data provided by registries participating in ICBP SURVMARK-2 project. Data are owned by cancer registries and authors are not permitted to share these data externally except in aggregate form, e.g. publication. Any data request should be directed to each corresponding cancer registry.

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Acknowledgements

The authors would like to thank the ICBP management team of Cancer Research UK for managing the programme, the ICBP SURVMARK-2 Local Leads for advice to understand the data, for their contributions to the study protocol, and interpretation of the results, as well as, the ICBP Clinical Committees for their advice. We are grateful to the ICBP SurvMark-2 Academic Reference Group for providing independent peer review and advice for the study protocol and analysis plan development. Finally, we thank the ICBP Program Board for their oversight and direction. A complete list of all investigators can be found in Supplementary Information Table 8. ICBP is funded by the Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; NHS England; Norwegian Cancer Society; Public Health Agency Northern Ireland on behalf of the Northern Ireland Cancer Registry; DG Health and Social Care, Scottish Government; Western Australia Department of Health; Public Health Wales NHS Trust.

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Authors and Affiliations

  1. Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France

    Citadel J. Cabasag, Melina Arnold, Aude Bardot, Jacques Ferlay, Eileen Morgan, Freddie Bray & Isabelle Soerjomataram

  2. Biostatistics Research Group, Department of Health Sciences, University of Leicester, University Road, Leicester, UK

    Mark Rutherford

  3. Cancer Institute New South Wales, Sydney, NSW, Australia

    Alana Little

  4. Surveillance and Cancer Registry, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada

    Prithwish De

  5. Department of Surgery, University of Calgary, Calgary, AB, Canada

    Elijah Dixon

  6. Cancer Control Research, BC Cancer, Vancouver, BC, Canada

    Ryan R. Woods

  7. Nova Scotia Health Cancer Care Program, Registry & Analytics, Halifax, NS, Canada

    Nathalie Saint-Jacques

  8. Victorian Cancer Registry Division, Cancer Council Victoria, Melbourne, VIC, Australia

    Sue Evans

  9. Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden, Copenhagen, Denmark

    Gerda Engholm

  10. School of Population Health, University of Auckland, Auckland, New Zealand

    Mark Elwood

  11. Department of Upper Gastrointestinal Surgery, Bankstown‐Lidcombe Hospital and School of Medicine, Western Sydney University, Sydney, NSW, Australia

    Neil Merrett

  12. Fiona Stanley Hospital and Western Australian Department of Health, Perth, WA, Australia

    David Ransom

  13. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia

    Dianne L. O’Connell

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  1. Citadel J. Cabasag
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Contributions

Conceptualisation: CJC, IS, FB, and MA; data curation: MA, AB, and JF; formal analysis and visualisation: CJC and MR; funding acquisition: IS, FB, and MA; roles/writing—original draft: CJC; writing—review and editing: all authors.

Corresponding author

Correspondence to Citadel J. Cabasag.

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The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the IARC Ethics Committee, and where needed approval was also given by local (or national) ethical committees. This study was conducted according to the guidelines of the Declaration of Helsinki and used secondary cancer data from the cancer registries, thus not requiring individual re-consenting for the purpose.

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Cabasag, C.J., Arnold, M., Rutherford, M. et al. Pancreatic cancer survival by stage and age in seven high-income countries (ICBP SURVMARK-2): a population-based study. Br J Cancer 126, 1774–1782 (2022). https://doi.org/10.1038/s41416-022-01752-3

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