Year 2025 / Volume 117 / Number 10
Original
Shifting trends in pancreatic cancer incidence across generations in Spain (1992-2021)

557-563

DOI: 10.17235/reed.2025.11335/2025

Lucía Cayuela, Victoria Achaval, Gema Flox-Benítez, Aurelio Cayuela Domínguez,

Abstract
Background: this study examines the trends in pancreatic cancer (PC) incidence in Spain from 1992 to 2021, focusing on sex and age-specific patterns and the influence of age, period, and birth cohort. Methods: data from the Global Burden of Disease 2021 study and population estimates from the Spanish National Statistics Institute were analyzed. Age-standardized incidence rates (ASIR) were calculated. Joinpoint regression and age-period-cohort (A-P-C) models were applied to assess temporal trends and the effects of age, period, and birth cohort, with a particular focus on early-onset pancreatic cancer (EOPC), defined as diagnosis before age 50. Results: PC cases in Spain nearly doubled from 3,970 in 1992 to 7,830 in 2021. For individuals aged 50 and older, ASIR steadily increased before stabilizing or declining after 2018. In those under 50 years of age, trends varied by sex, with a decline in males (average annual percentage change [AAPC]: −1.2 %) and a slight initial increase followed by a sharper decrease in females (AAPC: −0.0 %). A-P-C analysis identified age as the primary incidence driver, with modest period effects and significant cohort effects. Peak relative risks occurred in males born from 1952-1957 and females born from 1962-1967, with subsequent cohorts showing declining risk. Conclusions: PC incidence in Spain has risen, largely due to an aging population. However, favorable cohort effects, likely linked to reduced smoking and healthier lifestyles, along with recent declines in ASIR, suggest the effectiveness of public health efforts. Despite declining EOPC trends, the increasing burden in older adults underscores the need for ongoing research and targeted prevention strategies.
Lay Summary
This study analyses the trends in pancreatic cancer (PC) in Spain from 1992 to 2021. While the total number of cases nearly doubled, recent data show a decline in age-standardized incidence rates since 2018, likely due to better tobacco control, diet, and healthcare. PC rates increase sharply after age 50, with a growing burden among older adults, while cases in the younger population remain stable or decrease. The gender gap in PC is narrowing, partly due to changes in smoking and lifestyle factors. The findings suggest that public health efforts, especially smoking control, have helped to reduce PC risk in younger generations, but the rising incidence in older adults calls for continued prevention strategies.
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Cayuela L, Achaval V, Flox-Benítez G, Cayuela Domínguez A. Shifting trends in pancreatic cancer incidence across generations in Spain (1992-2021). 11335/2025


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Publication history

Received: 11/05/2025

Accepted: 15/05/2025

Online First: 12/06/2025

Published: 10/10/2025

Article Online First time: 32 days

Article editing time: 152 days


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