Regional Trends and Forecasts of Pancreatic Cancer Incidence in Poland: A Voivodeship-Level Analysis of Risk Factors

Background: Pancreatic cancer is characterized by increasing incidence and high mortality in Poland and worldwide. The aim of this study was to assess the relationship between selected risk factors and the age-standardized incidence rate of pancreatic cancer at the voivodeship level in Poland, and to evaluate the accuracy of a prediction model. Methods: Age-standardized incidence rate data for 16 Polish voivodeships in 2011-2023 were obtained from the Polish National Cancer Registry. The risk factor burden for 2011-2019, expressed as disability-adjusted life years (DALYs) per 100,000 population, was obtained from the System Analysis and Implementation Database of the Polish Ministry of Health. A generalized estimating equation model was constructed to predict the age-standardized incidence rate, with multicollinearity addressed using variance inflation factor analysis. Predictions for 2020-2023 were validated against observed data, and forecasts for 2024-2030 were subsequently calculated. Results: The number of new pancreatic cancer cases in Poland increased in eight out of 16 voivodeships. The highest burden was recorded in the Masovian, Subcarpathian, Świętokrzyskie and Greater Poland voivodeships. Air pollution was positively associated with pancreatic cancer incidence. Predictions for 2020-2023 showed satisfactory agreement with observed data, with the largest discrepancy being equal to 4.1 in terms of the age-standardized incidence rate. Based on the models, the incidence of pancreatic cancer was projected for all of 16 voivodeships through to 2030. Conclusions: Air pollution is associated with the regional burden of pancreatic cancer in Poland. The generalized estimating equation prediction approach demonstrated acceptable accuracy and can support monitoring and public health planning at the voivodeship level.