Burden of pancreatic cancer among the Western Pacific Region and association with human resources for health from 1990 to 2021: Results from the Global Burden of Disease Study 2021.

Abstract

Objective: Pancreatic cancer is a global health challenge, yet the Western Pacific Region (WPR) lacks comprehensive analysis of its burden and human resources for health (HRH) distribution. This study aims to assess trends in pancreatic cancer and HRH density in the WPR and investigate their relationship.

Methods: Pancreatic cancer data from GBD 2021 and annual HRH density from GBD 2019 were analyzed. Joinpoint regression was used to analyze temporal trends of pancreatic cancer burden and HRH density across 31 countries of the WPR. Spearman's rank correlation analysis and generalized linear models were applied to investigate the association between HRH density and pancreatic cancer burden.

Results: From 1990 to 2021, pancreatic cancer incidence in the WPR increased by 209%, from 59,766 to 184,612 cases, with a 201% rise in mortality and a 152% increase in disability-adjusted life years (DALYs). In 2021, smoking and high fasting plasma glucose were major risk factors, responsible for 16.43% and 23.29% of deaths, respectively. HRH density was positively correlated with the age-standardized incidence (P=0.767), death (P=0.752), and DALYs (P=0.726) rates of pancreatic cancer, and in 2019, most countries' HRH densities were below the Universal Health Coverage targets.

Conclusions: Despite improvements in HRH, notable distribution inequalities and shortages persist, limiting capabilities in pancreatic cancer diagnosis and treatment. The positive association between burden and HRH density reflects improved diagnostics from HRH growth but persistent treatment insufficiency due to shortages, and suggests that targeted HRH investment, strengthened primary care, and integration of palliative care are crucial to alleviating the burden.