U.S. pancreatic cancer death rates crept up between 2000 and 2009, with an annual increase of 0.4%, according to the American Cancer Society 2013 Cancer Facts and Figures report. The incidence of the disease also inched up during that time.
Among the largely encouraging trends in U.S. cancer mortality and incidence, pancreatic cancer is a grim exception, according to the American Cancer Society (ACS) 2013 Cancer Facts and Figures report. ACS statisticians predict that 45,220 Americans will be diagnosed with pancreatic cancer in 2013 and 38,460 will die from it.
The overall U.S. death rate for cancer declined by 20% from 1991, the peak year, to 2009, the latest year with complete data, according to the “Cancer Statistics, 2013” article that was published along with the ACS report in January.
However, the U.S. pancreatic death rate crept up between 2000 and 2009, increasing by 0.4% per year for both men and women. The incidence of the disease also inched up by 0.8% per year for men and by 0.9% per year for women during that time.
This year's version of the ACS report trains a spotlight on pancreatic cancer because it “is one of the most deadly cancers,” explains Ahmedin Jemal, DVM, PhD, the ACS vice president for surveillance and health services research. “Pancreatic and liver cancer are the only two cancers for which, in both men and women, the incidence and death rates have been going up.”
Both cancers are associated with obesity, so the obesity epidemic might be a partial explanation for the uptick in pancreatic and liver cancer rates in the United States, Jemal says.
The Facts and Figures report says tobacco use is the most important known modifiable risk factor for pancreatic cancer. Jemal, an epidemiologist, says stronger tobacco control policies—higher taxes on tobacco products; stronger smoke-free rules for workplaces, bars, and restaurants; and access to smoke cessation programs—would probably make the biggest dent in pancreatic cancer rates.
Only 15% to 20% of pancreatic cancer cases in the U.S. are diagnosed early enough for surgery to be a treatment choice with the potential to improve survival, Facts and Figures estimates. Imaging tests such as endoscopic ultrasound can identify early pancreatic cancer and precancerous lesions, the report notes, but researchers are still figuring out how these tests should be used in screening. For now, screening is limited to research studies of people with an elevated risk for developing pancreatic cancer based on genetic mutations and other factors.
In one positive development, a phase III clinical trial has shown that Abraxane (nab-paclitaxel; Celgene) plus gemcitabine can extend survival of late-stage, treatment-naïve pancreatic cancer patients. In the 860-patient MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) investigation, those treated with the Abraxane-plus-gemcitabine combination had a median overall survival of 8.5 months, versus 6.7 months for patients receiving the standard treatment of gemcitabine alone. The results were reported on January 25 at the American Society of Clinical Oncology 2013 Gastrointestinal Cancers Symposium in San Francisco, CA.