Rising Pancreatic Cancer Incidence in Young Japanese Women and Increasing Distal Pancreatectomy in Older Adults: A...

This nationwide observational study investigated recent trends in pancreatic cancer (PC) incidence and surgical management in Japan.

Annual data on PC incidence (2016-2021) and surgical procedures (2016-2023) were obtained from the Cancer Information Database and the National Database of Health Insurance Claims and Specific Health Checkups (NDB), respectively. Surgical procedures were categorized by type (distal pancreatectomy (DP, 2016-2023)/pancreatoduodenectomy (PD, 2020-2023)) and approach (open/laparoscopic). Crude and age-adjusted rates per 100 000 person-years were calculated. Temporal trends were evaluated using linear and Poisson regression to estimate annual risk ratios (RRs).

Over the study period, the annual average PC incidence was 43 015, and the average number of PC surgery was 13 899. Age-adjusted PC incidence rates rose significantly among males, females, and both sexes (RR = 1.007, 1.016 and 1.011, respectively; p < 0.0001). A particularly notable rise was observed among females aged 10-29 years (RR range: 1.347-1.449; all p < 0.0009). DP rates increased significantly among males, females, and both sexes (RR = 1.033, 1.032, and 1.033, respectively; p < 0.0001), with marked increases among individuals aged 65-89 years for both sexes (RR range: 1.018-1.114; all p < 0.0012). PD volumes also rose during 2020-2023, although the limited analytic window precluded formal rate-based trend evaluation. In 2023, PD comprised 65.6% of PC surgeries (9444/14397), while DP comprised 34.4% (4953/14397).

These nationwide findings highlight age- and sex-specific signals-notably an apparent rise among young women and increased DP use among older adults-that warrant further validation.