Trends in Pancreatic Cancer Mortality in Europe and the USA, 1990-2024, and Predictions to 2030

Abstract

Introduction

Pancreatic cancer is the fourth leading cause of cancer-related mortality in Europe, accounting for approximately 140,000 deaths in 2024. While mortality for many major cancers has declined over recent decades, pancreatic cancer did not decline and is characterized by a poor prognosis and high fatality rates. This reflects the lack of population screening, the high proportion of diagnoses at advanced stages due to nonspecific symptoms, and the limited efficacy of current treatment. Monitoring mortality trends and geographical inequalities across Europe is therefore essential to assess the evolving disease burden.

Objectives

The aim of this study was to describe pancreatic cancer mortality trends in Europe and the USA from 1990 to 2024 and to investigate differences across countries and sexes.

Methods

Pancreatic cancer death counts for the period 1990-2024 were obtained from the World Health Organization, while population estimates were retrieved from the United Nations Population Division. Analyses were restricted to European countries with at least 1 million inhabitants, no ongoing armed conflicts, medium-to-high mortality data quality (usability ≥60%), and at least 20 years of available data. The USA was also considered. Age-standardised mortality rates (ASMRs) per 100,000 were computed for each country and the EU-27 using the world standard population. Joinpoint regression models were used to identify significant changes in mortality trends, estimating annual percentage changes (APCs) for each time segment and average annual percentage changes over the entire study period. For the EU-27 and the USA, mortality rates were projected up to 2030.

Results

Twenty-nine European countries and the USA were included. In the triennium 2020-2022, ASMRs for pancreatic cancer in the EU-27 were 8.06 per 100,000 males and 5.15 per 100,000 females, while in the USA they were 7.35 in males and 5.59 in females. The highest mortality rates were observed in Hungary, Latvia, and the Czech Republic, where ASMRs exceeded 10 per 100,000 males and 7 per 100,000 females. Recent trends showed decreasing mortality among males in the EU-27 (APC 2018-2023: -0.6, 95% CI: -1.0, -0.2) and no significant changes among females (APC 2019-2023: -0.3, 95% CI: -1.0, 0.4). In the USA, mortality rates did not significantly change among males (APC 2001-2023: -0.0, 95% CI: -0.1, 0.1), whereas an upward trend was observed among women (APC 2002-2023: +0.2, 95% CI: 0.1, 0.3). By 2030, ASMRs in the EU-27 is predicted to reach 7.64 (95% Prediction interval, PI: 7.38, 7.91) per 100,000 males and 5.56 (95% PI: 5.23, 5.91) per 100,000 females in the EU-27. Corresponding figure for the USA were 7.36 (95% PI: 7.26, 7.46) per 100,000 males and 5.69 (95% PI: 5.59, 5.78) females.

Conclusions

Overall, pancreatic cancer mortality in the EU-27 and the USA has stopped rising among men since the mid-2020s and is predicted to moderately decline through 2030. However, several European countries showed stable or increasing mortality, while trends remained less favourable among women. The results confirm the limited progress in reducing the burden of this highly lethal malignancy and reveal important geographical inequalities across Europe, reflecting differences in tobacco smoking, obesity, and diabetes.