Incidence, diagnostic, traitement et pronostic du cancer du pancréas : évolution en Côte-d'Or de 1976 à 1985

: The aim of this study was to analyze the epidemiological aspects of pancreatic cancers and their time trends in the Cote-d'Or population between 1976 and 1985. Over a period of ten years, 444 cases were diagnosed. The incidence rates standardized according to the world reference population were 8.2/100,000 in males and 3.8/100,000 in females. The Cote-d'Or is an intermediate risk area for pancreatic cancer. This cancer was slightly more common in urban than in rural areas (NS). The initially urban predominance of pancreatic cancer in males was no longer present 10 years later. Between 1976 and 1985, incidence of pancreatic cancer decreased by a mean of 4.7% per year in males (NS) and 0.5% per year in females (NS). A high proportion of the cancers (73.9%) were located in the head of the pancreas; among histologically confirmed cases, 69.7% were adenocarcinomas. Criteria for diagnosis evolved throughout the 10 years. The rate of histological confirmation increased annually by a mean of 3.0% (P less than 0.001). The relative importance among diagnostic procedures of direct biliary and pancreatic examinations decreased (P less than 0.05) whereas that of ultrasonography and radioscan increased (P less than 0.001). The overall surgical rate was 64.4% and the rate of curative surgery was 4.4%. The operability rate increased annually by a mean of 2.0% (NS). The overall survival rate was 13.2% after 1 year, 4.5% after 3 years and 3.2% after 5 years. Prognosis depended neither on age nor on sex or cancer location. The 5-year survival rate was 38.5% in the limited group of patients (n = 13) who underwent surgery for cure, and 0.0% in patients with palliative treatment. These data emphasize the severity of pancreatic cancers and the absence of any therapeutical improvement between 1976 and 1985 in spite of the evolution in diagnostic procedures.