Pancreatic cancer in England and Wales 1975-2000: patterns and trends in incidence, survival and mortality.

Summary Background  Rates and time trends in mortality from pancreatic cancer vary considerably between countries. Aim  To examine trends and patterns in the incidence of, and the survival and mortality from, pancreatic cancer in England and Wales from 1975 to 2000; in particular, whether incidence and survival rates are related to socio-economic deprivation. Methods  We calculated annual age-specific and overall age-standardized incidence and mortality rates by sex for pancreatic cancer in total, and by subsite. We also estimated survival by sex and age group and by subsite. Results  In males, the age-standardized rate fluctuated in the late 1970s, to peak at 13.0 per 100 000 in 1979, declined steadily by an average of 1.3% per year to around 10.3 per 100 000 in the mid-1990s and then levelled off. For females, the rate peaked at 8.4 per 100 000 in the late 1980s before declining and fluctuating around 7.7 per 100 000 in the late 1990s. Patterns and trends in mortality rates were closely similar to those in incidence, due to the very low survival rates: only 2–3% at 5 years from diagnosis. Survival rates improved only minimally over the period 1971–99. Incidence and mortality rates were slightly higher in both males and females living in the most deprived areas, but survival was not consistently related to socio-economic deprivation. Conclusions  The incidence of, and mortality from, pancreatic cancer in England and Wales have fallen from peak levels observed in the 1970s and 1980s, and levelled off in the 1990s for both sexes; survival rates remain very low.