Secular Trends in Incidence, Prevalence, and Survival of Pancreatic Cancer in the United Kingdom: A Population-Based Cohort Study from 2000 to 2021

BackgroundPancreatic cancer is the seventh leading cause of cancer-related mortality worldwide and the fifth in the United Kingdom (UK), with incidence rates nearly matching mortality. MethodsWe conducted a population-based cohort study using Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases including patients aged 18+ with at least one year of prior data, diagnosed between 2000 and 2021. We estimated incidence, period prevalence, and survival at one, five, and ten years, stratified by age, sex, and calendar year. ResultsA total of 10,116 (GOLD) and 20,127 (Aurum) patients were included (median age 73 years, 50% male). Crude incidence rose from 6.9 per 100,000 person-years in 2000 to 14.2 in 2021. Age-standardized rates were lower towards the end of the study. Period prevalence increased from 0.01% to 0.03% over the same period. Median survival was 0.38 (95% CI 0.36-0.39) years in GOLD and 0.39 (95% CI 0.38-0.40) in Aurum. One-, five-, and ten-year survival were 25.3-26.2%, 6.1-6.6%, and 3.8-4.0%, respectively, with no differences by sex. One-year survival improved from 22.5% (95% CI 20.2-25.1) in 2000-2004 to 28.4% (95% CI 26.5-30.5) in 2015-2019. ConclusionsPancreatic cancer incidence and prevalence are increasing in the UK. Rising incidence may partly reflect population aging. Survival remains poor, with only modest short-term improvements. Small improvements in survival highlight more research is needed to improve earlier diagnosis which will lead to better patient outcomes. KEY MESSAGESO_LIThis study aimed to assess long-term trends in the incidence, prevalence, and survival of pancreatic cancer in the United Kingdom using two large primary care databases. C_LIO_LIWe found that both incidence and prevalence of pancreatic cancer have increased between 2000 and 2021, while survival has remained poor, with only modest short-term improvements. C_LIO_LIThese findings highlight the urgent need for strategies focused on early diagnosis and prevention, particularly considering population aging and the increasing burden of modifiable risk factors. C_LI