The current state of pancreatic cancer in Canada: incidence, mortality, and surgical therapy.
OBJECTIVE
This study aimed to evaluate the trends in the incidence, survival, and surgical therapy for Canadian patients affected by pancreatic cancer (PC).


METHODS
The incidence, mortality, number of resections, and outcomes of patients with PC stratified by year, sex, and province were extracted from Canadian cancer databases.


RESULTS
In 2012, PC was diagnosed in 4600 Canadians and it was responsible for 4300 deaths. The age-standardized incidence was 9 to 10 new cases per 100,000 individuals. The mortality rate remained the highest among all the solid tumors with a case-to-fatality ratio of 0.93. The age-standardized 5-year relative survival was 9.1% (95% confidence interval [CI], 8.3-10). There were geographic variations among provinces with the highest survival registered in Ontario (10.9%; 95% CI, 9.9-12) and the lowest survival reported in Nova Scotia (4.7%; 95% CI, 2.8-7.2). The percentage of patients who underwent surgery decreased from 19% (2006-2007) to 17% (2009-2010). Pancreatic resections were performed in high-volume centers in 74% of cases. In-hospital mortality was 5%, 93% of patients were discharged home, and 36% of patients required home support after discharge.


CONCLUSIONS
Long-term outcomes of Canadian patients affected by PC remain unsatisfactory, with only 9% of the patients surviving at 5 years. Surgical therapy was performed only in 17% to 19% of patients.
From the Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Scott
S
Hurton
Frank
F
MacDonald
Geoff
G
Porter
Mark
M
Walsh
Michele
M
Molinari
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D005843:Geography; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult