title: Pancreatic cancer mortality in Egypt: comparison to the United States pancreatic cancer mortality rates.
abstract: OBJECTIVE
  Little is known about the descriptive epidemiology of pancreatic cancer in many developing countries, such as Egypt. It is believed to be rare in developing countries, but this may reflect lack of systematic cancer registration. Mortality may serve as a surrogate for incidence, since the disease is lethal. Because of availability of reliable mortality registration in Egypt, we used the national mortality data to estimate pancreatic cancer mortality in 2765 deaths from 2000 to 2004, and to gain insights into the disease incidence.
  
  
  METHODS
  Mortality data in Egypt was obtained from the electronic national mortality records of the Ministry of Health. We calculated population-based age-specific and age-standardized pancreatic cancer mortality rates for Egypt, and compared them with the Surveillance, Epidemiology, and End Results (SEER) mortality data of the United States.
  
  
  RESULTS
  Comparisons of age-specific mortality demonstrated higher rates in Egypt compared to the United States for subjects under age 20 years (relative risks (RR) of 7.7 and 4.2, for the age groups 0-15 and 15-20, respectively), and significantly higher rates in the United States compared to Egypt for subjects 40 years and older (RR 1.8-80.5 for the age groups of 40-45 to 75+). For the majority of age groups in Egypt and the United States, mortality in males was higher than in females. Analysis of regional distribution of pancreatic cancer mortality in Egypt showed significant variations in rates among provinces (p<0.0001) with Northern provinces having average rate that is 2.85 times the rate of Southern provinces. The highest mortality rates were observed in the Nile Delta compared to southern Egypt and the oasis.
  
  
  CONCLUSIONS
  The findings of this study demonstrate both international and regional variation in pancreatic cancer mortality, and highlight the importance of further investigation to explore the possible factors that may contribute to the observed epidemiological patterns.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA. asoliman@umich.edu
authors.forename: Amr S
authors.initials: AS
authors.lastname: Soliman
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.forename: Thanaa
authors.initials: T
authors.lastname: Saleh
authors.forename: Ali
authors.initials: A
authors.lastname: Zarzour
authors.forename: Mohei
authors.initials: M
authors.lastname: Selim
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abdel-Fattah
authors.forename: James L
authors.initials: JL
authors.lastname: Abbruzzese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D002648:Child; D002675:Child, Preschool; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000401:mortality*; D018426:SEER Program / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American