Introduction

Pancreatic cancer is the fourth most common causes of cancer death in Europe and remains one of the malignancies with the poorest survival. The European Cancer Information System (ECIS) provides cancer incidence and mortality data from Population-Based Cancer Registries (PBCRs). The study aimed to explore geographical and time trend differences in the incidence and mortality of pancreatic cancer in Europe.

Methods

Age-standardised incidence and mortality rates were extracted from ECIS for cases ≥20 years, stratified by PBCR, sex and age group (20-49;≥50years). Geographic analysis included PBCRs with data from 2019 onwards. Ninety-five percent confidence intervals (95%CI) and mortality-to-incidence ratios were computed. Annual percent changes in incidence and mortality were estimated using Joinpoint regression in PBCRs with ≥10 years of data.

Results

Thirty-six PBCRs from 18 countries were analysed. Incidence ranged from 14.5 (95%CI:14.0-15.0) to 32.4 (95%CI:29.7-35.1) per 100,000 person-year in males and from 11.1 (95%CI:10.7-11.5) to 25.2 (95%CI:23.6-26.8) in females, with German PBCRs representing the extremes. The highest mortality rates were observed in Castellón, 48 (95%CI:41.4-54.6) in males and 29.8 (95%CI:25.1-34.5) in females, and the lowest in Brandenburg-Berlin for males at 15.3 (95%CI:14.9-15.7) and in the lowest in Agrigento for females at 8.8 (95%CI:4.7-12.9). Approximately 80% PBRCs reported significantly higher incidence and mortality rates in males. Mortality-to-incidence ratios were close to 1 in 90% PBCRs. In the 20-49 age group, incidence in both sexes and mortality in females were stable in over 80% of PBCRs, while mortality decreased significantly to 30.3% in males. Among cases in the ≥50 age group, incidence increased significantly in 40% of PBCRs and mortality in 30%.

Conclusions

Pancreatic cancer shows geographical differences in incidence and mortality across Europe, with higher rates in males and increasing trends in the ≥50 age group. A mortality-to-incidence ratio close to 1 highlights persistently poor survival. ECIS provides incidence and mortality indicators, although survival data were not available.