Abstract

Background: There is a paucity of data comparing the rates and time trends of pancreatic cancer in the southern and the total United States (US), as the risk factors for this cancer are disproportionately distributed in these two regions. The aim of this study was to compare the burden of this fatal cancer in these large geographic regions.

Methods: Age-adjusted incidence and mortality rates for patients (≥40 years) diagnosed with pancreatic cancer between 2000 and 2008 were calculated using the SEER 17 (southern and total US) data. Joinpoint regression was utilized to test the relationships between time and pancreatic cancer estimates. Relative, cause-specific, and conditional survival rates were also calculated for those diagnosed between 2000 and 2007.

Results: For both the study regions, an increase in incidence and mortality rates was observed in the older age groups (≥60 years), males, and blacks. The overall mortality rate in the southern states was slightly higher (26%) compared to the total US states (25%), with similar incidence rates observed in the two regions (27%). The annual percent increase (APC) in incidence rates was significant for all races and females in the southern states, but for all races and both the sexes in the total US. White females and black males in the southern states had higher three and five-year relative survival rates compared to their counterparts in the total US states.

Conclusion: Region-specific similarities and differences in incidence, mortality, and survival for pancreatic cancer were observed in the two regions. Particularly for the southern states, white females were at a significantly higher risk for developing this aggressive cancer compared to their male counterparts, and the incidence rate dramatically decreased for Asian/Pacific Islanders compared to other race/ethnic groups. These findings could have implications regarding preventive care services and treatment options for particular subgroups in the south.

Keywords: Pancreatic cancer, incidence, trends, mortality, relative survival, SEER Cancer Registries