title: A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs.
abstract: OBJECTIVE
  The purpose of this study was to assess the overall burden of pancreatic cancer in Europe, with a focus on survival time in a real-world setting, and the overall healthy life lost to the disease.
  
  
  METHODS
  Real-world data were retrieved from peer-reviewed, observational studies identified by an electronic search. We performed two de novo analyses: a proportional shortfall analysis to quantify the proportion of healthy life lost to pancreatic cancer and an estimation of the aggregate life-years lost annually in Europe.
  
  
  RESULTS
  Ninety-one studies were included. The median, age-standardised incidence of pancreatic cancer per 100,000 was 7.6 in men and 4.9 in women. Overall median survival from diagnosis was 4.6 months; median survival was 2.8-5.7 months in patients with metastatic disease. The proportional shortfall analysis showed that pancreatic cancer results in a 98 % loss of healthy life, with a life expectancy at diagnosis of 4.6 months compared to 15.1 years for an age-matched healthy population. Annually, 610,000-915,000 quality-adjusted life-years (QALYs) are lost to pancreatic cancer in Europe. Patients had significantly lower scores on validated health-related quality of life instruments versus population norms.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study to systematically review real-world overall survival and patient outcomes of pancreatic cancer patients in Europe outside the context of clinical trials. Our findings confirm the poor prognosis and short survival reported by national studies. Pancreatic cancer is a substantial burden in Europe, with nearly a million aggregate life-years lost annually and almost complete loss of healthy life in affected individuals.
authors.affiliation: Medical Oncology Department, Ramon y Cajal University Hospital, Ctra. Colmenar Viejo Km. 9,100, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Carrato
authors.forename: A
authors.initials: A
authors.lastname: Falcone
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.forename: J W
authors.initials: JW
authors.lastname: Valle
authors.forename: A
authors.initials: A
authors.lastname: Parnaby
authors.forename: K
authors.initials: K
authors.lastname: Djazouli
authors.forename: K
authors.initials: K
authors.lastname: Alnwick-Allu
authors.forename: A
authors.initials: A
authors.lastname: Hutchings
authors.forename: C
authors.initials: C
authors.lastname: Palaska
authors.forename: I
authors.initials: I
authors.lastname: Parthenaki
mesh_terms: D000368:Aged; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000401:mortality; D011788:Quality of Life; D016019:Survival Analysis