What is pancreatic cancer?
In 2011 there were about 3,600 men and 3,700 women diagnosed with pancreatic cancer in England, accounting for 2.6% of all newly diagnosed male cancers and 2.7% of all newly diagnosed female cancers (Office for National Statistics, 2013a).
The pancreas carries out two main functions in the body: producing digestive enzymes which break down food so that it can be absorbed and producing insulin which regulates blood sugar levels. Pancreatic cancer has very few symptoms in its early stage so is often diagnosed when the disease is advanced. The primary symptoms of pancreatic cancer include weight loss, stomach pain and jaundice, and these symptoms are associated with a number of conditions. (NHS Choices, 2012).
Incidence and mortality rates have remained relatively stable
Incidence rates for pancreatic cancer have remained fairly stable over the past 40 years. In 1971 there were 11.4 newly diagnosed cases per 100,000 men and 6.9 cases per 100,000 women. This compares with 10.7 newly diagnosed cases per 100,000 men in 2011 and 8.6 new cases per 100,000 women.
In 2011, around 3,500 men and 3,500 women died of pancreatic cancer in England. Since 1971 mortality rates have followed incidence rates closely. In 1971 there were 11.3 deaths per 100,000 men compared to 10.3 deaths per 100,000 men in 2011. Mortality rates among women increased from 6.7 deaths per 100,000 women in 1971 to 7.9 deaths per 100,000 women in 2011.
Figure 1: Pancreatic cancer incidence and mortality rates, England, 1971-2011
- Pancreatic Cancer is coded to 157 in the International Classification of Diseases Eighth Revision (ICD-8), 157 in the International Classification of Diseases ninth Revision (ICD-9 ) and to C25 in the Tenth Revision (ICD-10).
- Age-standardised rates allow comparisons between areas or over time where populations have different age structures. The method used here is direct standardisation using the 1976 European Standard Population.
85% of newly diagnosed cases of pancreatic cancer are in those aged 60 and over
Little is known for certain about the causes of pancreatic cancer (Pancreatic Cancer UK, 2013); however, some risk factors have been identified. As with many other cancers age is a major risk factor. Pancreatic cancer predominately affects the elderly, with more than 85% of cases being diagnosed in those aged 60 and older. Pancreatic cancer is most commonly diagnosed in men aged 70-74; 16% of diagnoses of pancreatic cancer in men is in this age group. However, 19% of newly diagnosed cases of pancreatic cancer were for women aged 85 and older.(Office for National Statistics, 2013a).
Other risk factors include smoking, a family history of pancreatic cancer and having certain medical conditions like pancreatitis or diabetes (NHS Choices, 2012). There is also evidence that those who are obese are at a greater risk of developing pancreatic cancer (Berrington et al., 2003, Stolzenberg-Solomon et al., 2008).
Little improvement in survival for those diagnosed with pancreatic cancer
Survival of pancreatic cancer is the lowest of 21 commonly diagnosed cancers (Office for National Statistics, 2013b). Among adults (aged 15-99 years) diagnosed with pancreatic cancer between 1971 and 1975 and followed up to 1990, five-year survival was only 2.0% for both men and women (Coleman et al., 1999). For those diagnosed between 2007 and 2011 and followed up to 2012, the five-year survival estimate was 4.7% for men and 5.4% of women, an increase of 2.7 percentage points for men and 3.4 percentage points for women (Office for National Statistics, 2013b).
Despite these small increases, diagnosis of pancreatic cancer remains problematic. As such, improvements in survival have been very slow, not just in England but internationally (Coleman et al., 1999). Just under half of pancreatic cancer diagnoses are made through emergency presentation via accident and emergency departments or emergency GP referrals. Cancers diagnosed through emergency presentation are often advanced, or fast growing; therefore survival tends to be poorer for those diagnosed this way compared to other methods of diagnosis. (NCIN, 2010, MCPhail et al., 2013).
These statistics were compiled and analysed by the Cancer and End of Life Care Analysis team in the Life Events and Population Sources Division. If you’d like to find out more about our cancer statistics you can read our Annual Reference Volume and see further stories, for example on lung cancer. If you have any comments or suggestions, we’d like to hear them. Please email us at: firstname.lastname@example.org.