Unusually high rate of young-onset pancreatic cancer in the East Nile Delta region of Egypt.
BACKGROUND
Pancreatic cancer is predominantly a disorder of the elderly population in the United States. In Egypt, the disease has traditionally been considered rare, and there has not been a previous publication on its population-based incidence or age distribution.


METHODS
We reviewed the records of 728 pancreatic cancer patients seen at the Gastrointestinal Surgery Center of Mansoura University in the East Nile Delta region of Egypt between 1995 and 2000. We computed population-based, age-specific, and age-adjusted incidence rates in this population and compared them with US incidence rates from the Epidemiology Surveillance and End Results (SEER) Program. We also analyzed clinical characteristics of the patients, as well as their surgical and medical management.


RESULTS
Approximately one-fourth of all patients were under age 50. The mean ages of patients who had undergone Whipple's resection, other surgical procedures, and no surgical procedure were 52.9 +/- 11.6, 54.11 +/- 10.5, and 55.1 +/- 14.1 yr, with no statistically significant differences. Age-adjusted incidence rates were higher in Egyptian patients than in US patients under age 65 (7.1/100,000 vs 3.3/100,000) but were much higher in US patients than in Egyptian patients over age 65 (6.6/100,000 vs 59.1/100,000). Clinical management did not differ between patients under and over age 50.


CONCLUSIONS
The population in the East Nile Delta region of Egypt exhibits an unusually high rate of young-onset pancreatic cancer. Further studies to investigate the epidemiology of pancreatic cancer in this population may provide clues to its etiology.
Soliman
Amr S
AS
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center Houston, TX 77030, USA. asoliman@mdanderson.org
El-Ghawalby
Nabih
N
Ezzat
Farouk
F
Bondy
Melissa L
ML
Soultan
Ahmed
A
Abdel-Wahab
Mohamed
M
Fathy
Omar
O
Ebidi
Gamal
G
Bassiouni
Nadia
N
El-Ghawalbi
Ahmed
A
Levin
Bernard
B
Abbruzzese
James L
JL
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome