An analysis of pancreatic cancer data in younger adults found that while there is an increasing incidence of pancreatic cancer in young adults, the mortality rate remains stable.

This increased incidence seems to be due to increased detection of smaller, early-stage endocrine cancer, rather than an increase in pancreatic adenocarcinoma, suggesting the possibility of overdiagnosis.

These findings are published in Annals of Internal Medicine.

Researchers from Brigham and Women’s Hospital studied data from the U.S Cancer Statistics database and the National Vital Statistics System to examine the incidence, tumour size, stage distribution, and disease-specific mortality of pancreatic cancer in men and women aged 15 to 39 years from 2001 to 2019 to determine whether the observed increase in incidence of pancreatic cancer among young Americans represents a true increase in cancer occurrence.

The researchers defined four different histologic categories (adenocarcinoma, endocrine, solid pseudopapillary, and other) and investigated variables including tumour size and receipt of cancer-directed surgery.

The researchers found that between 2001 and 2019, pancreatic cancer incidence increased among both men and women, and the rate of cancer-directed pancreatic surgery more than doubled in both men and women.

The increase in incidence was attributable mostly to early-stage cancer, with the incidence of small tumours increasing from 0.22 to 1.8 per million in women and 0.33 to 1 per million in men.

The increase in incidence was not attributable to the dominant pancreatic cancer histology of adenocarcinoma, but rather to endocrine cancer and solid pseudopapillary neoplasms.

While there have been several reports in recent years raising concerns over the increase of pancreatic cancer among young people, this analysis indicates that the increase in incidence is primarily due to increased detection of smaller, early-stage endocrine cancer.

Stable mortality rates despite increases in incidence suggest the detection of previously undetected disease rather than an increase in actual pancreatic cancer occurrence.

The researchers warn that pancreatic cancer can be overdiagnosed – particularly when the different types of pancreatic cancer are lumped together – leading to an increase in high-risk pancreatic surgery.

Source: American College of Physicians