Trends in Pancreatic Cancer Incidence, Prevalence, and Mortality in the United States and High SDI Countries (1991–2021) and Future Projections: A Forecasting Population-Based Analysis

OBJECTIVES: Pancreatic cancer has poor prognosis and incidence is rising, particularly in high Socio-Demographic Index (SDI) countries. This study examines trends in pancreatic cancer incidence, prevalence, and mortality in the US and high SDI countries from 1991 to 2021 and uses modeling to project pancreatic cancer rates through 2041. METHODS: This retrospective, population-based observational study analyzed pancreatic cancer trends using the Global Burden of Disease (GBD) database. Primary outcome measures included age-standardized incidence (ASIR), prevalence (ASPR), and mortality (ASMR) rates, stratified by sex and region. Joinpoint regression analysis estimated annual percentage change (APC) with 95% confidence intervals (CIs) to identify significant trends. Autoregressive Integrated Moving Average (ARIMA) models were used to forecast rates from 2022-2041. RESULTS: From 1991 to 2021, pancreatic cancer ASIR, ASPR, and ASMR rose in both the US and high-SDI countries, with a sharp rise after 2001 and a plateau after 2016. ASIR peaked at 10.46 (US, 2016) and 10.24 (high SDI, 2018), with similar trends in ASPR and ASMR. APC analysis revealed a significant rise (p<0.001) in most periods through 2016, though rates recently declined between 2016-2020. Males consistently had higher rates compared to females. Projections of ASMR to 2041 continue to rise to 9.856 in high SDI countries and 9.813 in the US, leading to a projected 271,310 and 72,304 deaths, respectively. CONCLUSIONS: Pancreatic cancer incidence, prevalence and mortality have increased in the past two decades in both high SDI countries and the US. Rising incidence and prevalence are likely driven by a combination of improved diagnosis and treatment, as well as population aging, lifestyle, and environmental factors. Males have higher rates compared to females across both regions, a trend that has not yet been fully explained. Despite the recent stabilization of pancreatic cancer rates, modeling predicts a rise in all three metrics through 2041. Continued efforts are imperative to refine early diagnostic methods, identify modifiable risk factors, and develop effective interventions to reduce mortality.