Shifting trends in pancreatic cancer incidence across generations in Spain (1992-2021)

this study examines the trends in pancreatic cancer (PC) incidence in Spain from 1992 to 2021, focusing on sex and age-specific patterns and the influence of age, period, and birth cohort.

data from the Global Burden of Disease 2021 study and population estimates from the Spanish National Statistics Institute were analyzed. Age-standardized incidence rates (ASIR) were calculated. Joinpoint regression and age-period-cohort (A-P-C) models were applied to assess temporal trends and the effects of age, period, and birth cohort, with a particular focus on early-onset pancreatic cancer (EOPC), defined as diagnosis before age 50.

PC cases in Spain nearly doubled from 3,970 in 1992 to 7,830 in 2021. For individuals aged 50 and older, ASIR steadily increased before stabilizing or declining after 2018. In those under 50 years of age, trends varied by sex, with a decline in males (average annual percentage change [AAPC]: -1.2 %) and a slight initial increase followed by a sharper decrease in females (AAPC: -0.0 %). A-P-C analysis identified age as the primary incidence driver, with modest period effects and significant cohort effects. Peak relative risks occurred in males born from 1952-1957 and females born from 1962-1967, with subsequent cohorts showing declining risk.

PC incidence in Spain has risen, largely due to an aging population. However, favorable cohort effects, likely linked to reduced smoking and healthier lifestyles, along with recent declines in ASIR, suggest the effectiveness of public health efforts. Despite declining EOPC trends, the increasing burden in older adults underscores the need for ongoing research and targeted prevention strategies.