The Incidence Rate of Pancreatic Cancer for Ages 50-Years and Above-SEER Based Study-Should We Start Screening for Pancreatic Cancer?

Introduction: There are 28,000 to 30,000 newly diagnosed cases of pancreatic cancer (PC) in the United States yearly. The average age at diagnosis is 60 to 65 years with a 1-year survival rate of 19% and a 5-year survival rate of 4%. Late onset of symptoms can attribute to the extent of metastatic disease at diagnosis and therefore, a low survival rate. In this study, we explore the potential for establishing a screening protocol for PC. Methods: We used Incidence - SEER Research Limited-Field Data, 22 Registries, Nov 2021 Sub (2000-2019) which was released in April 2022, based on the November 2021 submission for the calculation of incidence rates of PC. SEER 22 covers approximately 47.9% of the U.S. population (based on the 2020 census). SEER*Stat 8.4.1 was used to obtain age-adjusted rates for different age-group. We used Join point software, version 4.9.1.0 by National Cancer Institute, annually to create log-linear time trends. Results: We identified 359,274 PC cases. The total cases of PC among 50-54 years, 55-59 years, 60-64 years, 65-69 years, 70-74 years, 75-79 years, 80-84 years, and 85+ years were 21,962, 34,526, 45,228, 52,517, 55,048, 53,811, 46,658, and 49,524 respectively. The incidence rate of PC is up trending in all age groups with higher rates with advancing age. Among age groups 50-54 years, 55-59 years, 60-64 years, 70-74 years, 75-79 years, and 80-84 years, the incidence rates are increasing at 0.9%* (95% CI [confidence interval], 0.7 to 1.2, P< 0.001), 1%* (95% CI, 0.7 to 1.2, P< 0.001), 1%* (95% CI, 0.7 to 1.2, P< 0.001), 0.7%*(95% CI, 0.5 to 0.8, P< 0.001), 0.9%*(95% CI, 0.7 to 1, P< 0.001), 0.6%* (95% CI, 0.4 to 0.8, P< 0.001) every year respectively. However, in ages 65-69 years, an increase in incidence rates was noted from 2004 to 2019 with an annual percentage change of 1.2* %* (95% CI, 1 to 1.4, P< 0.001). In the age group 85 years and higher, incidence rates increased from 2000 to 2008 at 1.4%* (95% CI, 0.8 to 2, P< 0.001) and declined later (Figure 1). Conclusion: Imaging techniques like magnetic resonance imaging and endoscopic ultrasonography (EUS) have already been used to screen for PC in genetically predisposed individuals. Incidence rates are relatively higher among individuals over 65 years and up trending. Individuals with known risk factors like cigarette smoking, obesity, diabetes mellitus, and heavy alcohol use would likely benefit from screening techniques but should be balanced against healthcare costs and expected life expectancy.Figure 1.: The incidence rate of pancreatic cancer for different age groups (Ages 50 and above).