Gender Difference in the Trend and Forecast Analysis of Changes in the Burden of Disease of Pancreatic Cancer Attributable to Smoking in China, 1990-2021.

Abstract

BackgroundPancreatic cancer is one of the most aggressive malignant tumors worldwide, often resulting in poor prognosis. Smoking is widely recognized as a significant risk factor for this disease.MethodsThis study extracted data on the disease burden of pancreatic cancer attributable to smoking in China from the Global Burden of Disease 2021 (GBD 2021) database. A total of 447 334 individuals were included in the analysis. A joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess trends in the disease burden from 1990 to 2021. The age-period-cohort model was applied to explain the epidemiological trends of the disease by controlling for variables associated with age, period, and birth cohort. Decomposition analysis was conducted to quantify the relative contributions of population growth, population aging, and epidemiological changes. The Autoregressive Integrated Moving Average (ARIMA) model was utilized to forecast the burden of pancreatic cancer due to smoking in China over the next 15 years.ResultsFrom 1990 to 2021, the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life years rate (ASDR) due to smoking-related pancreatic cancer in China exhibited an upward trend. By 2021, the total number of deaths and disability-adjusted life years (DALYs) had almost doubled compared to 1990. The mortality and DALY rates increased with age, peaking at approximately 85 years and 70 years, respectively, indicating a substantial burden on the elderly population. Furthermore, we predict that female ASMR and ASDR may start to decline in the next 15 years; however, the absolute burden remains unchanged. Conversely, the ASMR and ASDR for males continue to rise, indicating an increasing burden, with the male burden consistently surpassing that of females.ConclusionsThis study demonstrates that from 1990 to 2021, the burden of pancreatic cancer attributable to smoking in China has intensified, with significant disparities related to sex and age. The future outlook appears quite severe, given the large population base and accelerating population aging. Strong smoking cessation and control measures specifically targeting elderly males are imperative to limit tobacco exposure among high-risk groups, as these measures are crucial for alleviating the burden of pancreatic cancer in China.