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. 2020 Nov 1;112(11):1162-1169.
doi: 10.1093/jnci/djaa004.

Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis

Amanda L Blackford  1 , Marcia Irene Canto  1   2 , Alison P Klein  1   3 , Ralph H Hruban  1   3 , Michael Goggins  1   2   3
Affiliations

Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis

Amanda L Blackford et al. J Natl Cancer Inst. .

Erratum in

Abstract

Background: Rapid access to pancreatic imaging and regular pancreatic surveillance may help identify stage I pancreatic cancer. We investigated recent trends in the stage of newly diagnosed pancreatic ductal adenocarcinoma (PDACs), age at diagnosis, and survival.

Methods: Trends in age-adjusted incidence of stage IA PDAC between 2004 and 2016 were determined from the National Cancer Institute's Surveillance, Epidemiology and End Results database. All tests were two-sided.

Results: The incidence of stage IA PDAC cases diagnosed increased statistically significantly from 2004 to 2016 (annual percent change = 14.5, 95% confidence interval [CI] = 11.4 to 17.7; P < .001). During the study period, average age at diagnosis for stage IA and IB casesAQ3 declined by 3.5 years (95% CI = 1.2 to 5.9; P = .004) and 5.5 years (95% CI = 3.4 to 7.6; P < .001), whereas average age increased for higher-stage cases (by 0.6 to 1.4 years). Among stage IA cases, the proportion of blacks was smaller (10.2% vs 12.5%), and the proportion of other non-Caucasians was higher compared with higher-stage cases (11.9% vs 8.4%; P < .001). Stage IA cases were more likely to carry insurance (vs Medicaid or none) than higher-stage cases (cases aged younger than 65 years; odds ratio = 2.45, 95% CI = 1.96 to 3.06; P < .001). The 5-year overall survival for stage IA PDAC improved from 44.7% (95% CI = 31.4 to 63.7) in 2004 to 83.7% (95% CI = 78.6% to 89.2%) in 2012; 10-year survival improved from 36.7% (95% CI = 24.1 to 55.8) in 2004 to 49.0% (95% CI = 37.2% to 64.6%) in 2007.

Conclusions: In recent years, the proportion of patients diagnosed with stage IA PDAC has increased, their average age at diagnosis has decreased, and their overall survival has improved. These trends may be the result of improved early diagnosis and early detection.

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Figures

Figure 1.
Figure 1.
Age-adjusted incidence trends over time for pancreatic cancer stage IA–III, shown as age-adjusted incidence rates (2004–2016). Asterisks denote annual percent change (APC) with P < .05.
Figure 2.
Figure 2.
Age-adjusted incidence trends over time for pancreatic cancer stage IA within relevant subgroups. Trends shown according to (A) age, (B) race, (C) geographic SEER region, and (D) IPMN-related disease status. Asterisks denote annual percent change (APC) with two-sided P < .05. IPMN = intraductal papillary mucinous neoplasms.
Figure 3.
Figure 3.
Trends in 5-year overall survival probabilities according to pancreatic cancer stage (2004–2012).
Figure 4.
Figure 4.
Trends in mean age at diagnosis according to pancreatic cancer stage (2004–2016).
See this image and copyright information in PMC

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