The incidence and survival rate of population-based pancreatic cancer patients: Shanghai Cancer Registry 2004-2009

Abstract

Background: Pancreatic cancer is a devastating disease with dismal prognosis. Large population-based evidence on its survival rate and influence factors is lacking in China.

Objective: This study aimed to depict the demographic factors, tumor characteristics, incidence rate and survival rate of pancreatic cancer cases in urban China.

Methods: The demographic factors, tumor characteristics were collected for all the pancreatic cancer cases identified during 2004 to 2009 from the Shanghai Cancer Registry. The survival time was ascertained through linkage of the Shanghai Cancer Registry and the Shanghai Vital Statistics Registry. The deadline of death certificates was the end of December 2012. Kaplan-Meier method and Cox proportional-hazards regression model were used to explore the survival rate and influence factors.

Results: 11,672 new pancreatic cancer cases were identified among Shanghai residency during 2004 to 2009. The crude incidence rate of pancreatic cancer was increasing from 12.80/100,000 in 2004 to 15.66/100,000 in 2009, while the standardized incidence rate was about 6.70/100,000 and didn't change a lot. The overall 5-year survival rate was 4.1% and the median survival time was 3.9 (95% Confidence Interval (CI) 3.8-4.0) months. Subjects had received surgical resection had improved survival (HR = 0.742, 95% CI: 0.634-0.868) than its counterparts. In adjusted multivariable Cox proportional-hazard models, factors associated with poor survival included older age at diagnosis (age > = 70 years: hazard ratio (HR) = 1.827, 95% CI: 1.614-2.067), male sex (HR = 1.155, 95% CI: 1.041-1.281), distant disease at diagnosis (HR = 1.257, 95% CI: 1.061-1.488), positive lymph node (HR = 1.236, 95% CI: 1.085-1.408), tumor stage (Stage IV HR = 2.817, 95% CI: 2.029-3.909).

Conclusion: The age-adjusted incidence rate was stable and overall survival rate was low among pancreatic cancer patients of Shanghai residency. Early detection and improved treatment strategies are needed to improve prognosis for this deadly disease.

Figure 1. The incidence rate of pancreatic cancer of Shanghai residency during 2004–2009 (1/100,000).

Figure 2. The survival rate of pancreatic cancer patients among Shanghai residency, Shanghai Cancer Registry 2004–2009.

Whole population: 1-year survival rate 17.8%, 3-year survival rate 5.7%, 5-year survival rate 4.1%, Subjects underwent surgical resection: 1-year survival rate 47.5%, 3-year survival rate 15.4%, 5-year survival rate 10.1%, Subjects without surgical resection: 1-year survival rate 16%, 3-year survival rate 5.1%, 5-year survival rate 3.7%.

Figure 3. the survival rate of pancreatic cancer patients among Shanghai residency underwent surgical resection, Shanghai Cancer Registry 2004–2009.

Age <60: 1-year survival rate 54.8%, 3-year survival rate 19.8%, 5-year survival rate 13.9%, Age <70: 1-year survival rate 42.3%, 3-year survival rate 11.2%, 5-year survival rate 6.7%, Age>70: 1-year survival rate 40.8%, 3-year survival rate 12.3%, 5-year survival rate 6.2%.