Trends in the incidence of pancreatic adenocarcinoma in all 50 United States examined through an age-period-cohort analysis
Menée dans les 50 Etats américains sur la période 2001-2016, cette étude analyse l’évolution de l’incidence de l’adénocarcinome du pancréas, en fonction du sexe et de l’origine ethnique
Background : Pancreatic ductal adenocarcinoma (PDAC) is a major contributor to cancer-related mortality in the U.S. We aimed to investigate trends in incidence rates from all 50 states from 2001 to 2016, overall and by race, sex, and state, and using age-period-cohort analyses. Methods : Age-adjusted incidence rates and trends in adults aged ?35 years were calculated using data from the U.S. Cancer Statistics registry. We used joinpoint regression to compute annual percent changes (APC) and average annual percent changes (AAPC). We also analyzed incidence trends by age groups and birth cohorts through age-period-cohort modeling. Results : Age-standardized incidence rates increased by 1.23% (95% CI 0.92, 1.54) annually between 2001 and 2008, but were stable between 2008 and 2016 (APC=0.11%, 95% CI -0.13, 0.35). APCs and inflection points were no different for men and women. Rates increased statistically significantly among non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) between 2001-2007 and 2001-2008 respectively, but in later years rates increased slowly among NHWs (APC=0.36%, 95% CI 0.12, 0.60), and were stable among NHBs (APC=-0.40%, 95% CI -0.89, 0.10). The number of states with age-standardized incidence rates ?20.4 per 100,000 increased from 16 in 2001-2003 to 40 by 2015-2016. We found a strong birth cohort effect in both men and women and increasing rates among successive birth cohorts of NHWs. Conclusions : The incidence of PDAC has consistently increased in the U.S., albeit at slower rates recently. We observed notable increases among NHWs and in some states in the central and southern part of the country.