International variation in pancreatic cancer mortality for the period 1955-1998.
BACKGROUND
Pancreatic cancer is an important cause of cancer mortality in developed countries. This article examines time trends for pancreatic cancer mortality rates in 38 countries on five continents between 1955 and 1998.


METHODS
We used the World Health Organization database on Age-Standardized World Population pancreatic cancer mortality rates by gender and fitted these data with linear regression models. This allowed us to (1) investigate the statistical significance of temporal trends; and (2) consider differences in trends among countries; and (3) predict future pancreatic cancer mortality rates.


RESULTS
Over 44 years, pancreatic cancer mortality rates increased for females worldwide. Pancreatic cancer mortality rates for men increased in Southern Europe. In contrast, pancreatic cancer mortality rates for men in North America and Oceania increased until about 1975 and then decreased or remained stable. Our predictive models suggest that by 2005 the relative burden of pancreatic cancer mortality will have shifted away from Northern Europe and North America toward Southern Europe and Asia.


CONCLUSIONS
Future research on pancreatic cancer should concentrate separately on the assessment of risk attributable to exposure to environmental factors, lifestyle factors, genetic determinates of pancreatic cancer, and the interactive influences of these factors on pancreatic cancer.
Sahmoun
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AE
Department of Public Health Sciences, Wake Forest University School of Medicine, Comprehensive Cancer Center, Winston-Salem, NC 27157-1082, USA. asahmoun@wfubmc.edu
D'Agostino
R A
RA
Bell
R A
RA
Schwenke
D C
DC
D005260:Female; D005544:Forecasting; D014943:Global Health; D006801:Humans; D016014:Linear Models; D008297:Male; D010190:Pancreatic Neoplasms / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D013995:Time; D014944:World Health Organization