INTRODUCTION:Acute pancreatitis (AP) is a common inflammatory disorder that is associated with increased risk for diabetes mellitus (DM). It remains unclear whether recurrent acute pancreatitis (RAP) is associated with further increased risk of incident DM. This study aims to investigate the association between RAP and incident DM using real-world data. METHODS:We conducted a retrospective cohort study using the MerativeTM MarketScan® claims database (2016-2023), identifying patients with AP and no prior history of DM at baseline. The primary exposure of interest, RAP, was defined as one or more episodes of AP occurring ≥90 days after the index AP diagnosis, whereas one episode of AP referred to a single episode of AP (SAP) with no subsequent recurrence within 90 days following the index event. A multivariable stratified Cox proportional hazards regression models were used to determine the association between RAP and incident DM, identified using ICD-10 codes. RESULTS:In total, 16,184 individuals with AP (mean [SD] age: 45.8 [12.3]) contributed 40,712 person-years of follow-up, during which 1,477 incident cases of DM were documented. Individuals with RAP had an increased risk of incident DM compared with those with a SAP(adjusted HR, 1.92; 95% CI, 1.61-2.29). The risk increased significantly with the frequency of RAP. In comparing the modifying effect of patient demographics and comorbidities, a stronger association between RAP and incident DM was observed in females (adjusted HR, 2.44; 95% CI, 1.87-3.19) than in males (adjusted HR, 1.64; 95% CI, 1.30-2.07; Pinteraction=0.03). Also, stronger associations were observed among younger patients (18-46 y) (adjusted HR=2.56; 95% CI, 1.97-3.31) and among non-tobacco abuse (adjusted HR=2.19; 95% CI, 1.81-2.65), with significant interactions for all comparisons (Pinteraction<0.05. CONCLUSIONS:In this real-world study, RAP was associated with an increased risk of incident DM. Our findings highlight an opportunity for glycemic monitoring and proactive management of patients with RAP to mitigate their risk of developing DM.
OBJECTIVES:Acute pancreatitis (AP) is a painful and potentially life-threatening disorder, with no effective therapy available to date. Genome assessment shows promise as a potential method for predicting AP severity. We hypothesized that single nucleotide polymorphisms (SNPs) and expression changes in Heat Shock Protein 70 (HSP70) family genes may play a role in early prediction of AP severity. METHODS:A total of 44 AP patients and 47 age- and sex-matched healthy controls were studied. Leukocyte-extracted total RNA and genomic DNA were used for HSPA1A and HSPA1L gene expression and genotyping in promoter regions (HSPA1A: rs1008438 and HSPA1L: rs2227956) analyses, respectively. RESULTS:No statistically significant differences were found between the genotypes of AP patients and controls, however, HSPA1A expression was 2-fold lower in AP. Decrease in expression was more evident in mild and mild/moderate AP groups vs. controls (P=0.024 and P=0.008, respectively). HSPA1L expression in AG vs. AA carriers was higher in entire cohort (P=0.014) and markedly differed between AP patients (P=0.001). Also, HSPA1L expression was the highest in severe AG cases and significantly differed from AA genotype carriers (P=0.005). CONCLUSIONS:We suggest that HSP70 family genes expression may be a valuable marker for predicting disease severity in AP.
OBJECTIVES:The cachexia index (CXI), integrating skeletal muscle mass, serum albumin, and the neutrophil-to-lymphocyte ratio, has been proposed as a marker of cancer-related cachexia. The objective of this study was to assess the prognostic significance of pre-treatment CXI in patients with resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC) undergoing neoadjuvant chemotherapy (NAC) followed by resection. METHODS:We retrospectively analyzed 75 patients with resectable or borderline resectable PDAC who underwent NAC followed by curative resection (2012-2023). CXI was calculated using total skeletal muscle area (S-CXI) and psoas muscle area (P-CXI). Patients were stratified into low and normal groups using sex-specific tertiles. RESULTS:Baseline and pathological characteristics were comparable between groups. Low S-CXI was significantly associated with shorter recurrence-free survival (P=0.02) and overall survival (P=0.013). Multivariate analysis demonstrated that low S-CXI remained independently associated with both recurrence (HR 1.81, P=0.045) and mortality (HR 2.16, P=0.033); lymph-node metastasis was also associated with mortality. P-CXI was not associated with outcomes. CONCLUSIONS:Pre-treatment S-CXI showed potential prognostic value for survival in patients with PDAC undergoing NAC followed by resection. This simple index may help identify high-risk patients who could benefit from perioperative multidisciplinary interventions. Prospective validation is warranted.
BACKGROUND:Primary hyperparathyroidism (PHPT) is a rare but notable metabolic cause of acute pancreatitis (AP). Early diagnosis and surgical intervention are crucial to prevent recurrence and improve prognosis. METHODS:We retrospectively analyzed the clinical data of a 61-year-old male presenting with AP and severe hypercalcemia (3.54 mmol/L) as the initial manifestation of PHPT. Additionally, a systematic review of 83 studies published between 1958 and May 2026 was performed in accordance with PRISMA guidelines. Individual patient data (IPD) on demographics, total serum calcium levels, treatment modalities, and clinical outcomes were extracted. RESULTS:The patient's total serum calcium was 3.54 mmol/L (14.16 mg/dL) with a parathyroid hormone (PTH) of 640.5 pg/mL. Unenhanced abdominal computed tomography (CT) confirmed acute pancreatitis (AP; moderately severe acute pancreatitis according to the Revised Atlanta 2012 classification), and a left inferior parathyroid adenoma was identified via cervical ultrasonography and 99mTc-MIBI scintigraphy. Total serum calcium normalized following parathyroidectomy (PTX), with resolution of symptoms. A systematic review of 107 patients with primary hyperparathyroidism-associated pancreatitis (PHPT-AP) showed the median age was 38 years (IQR 26-56, range 11-88), 41.1% male, and the median peak total calcium was 3.25 mmol/L (IQR 2.98-3.82, range 2.55-5.36). PTX was performed in 88.8% of the cases. CONCLUSION:PHPT is a treatable cause of acute pancreatitis and should be considered in cases of idiopathic or recurrent pancreatitis. Routine screening of total serum calcium and PTH levels is recommended for idiopathic or recurrent AP. For PHPT-AP patients with hypercalcemic crisis (>3.75 mmol/L or >15 mg/dL), early parathyroidectomy after medical stabilization (traditionally recommended within 72 hours, although modern evidence supports optimization over 48 hours up to 1 week) is safe and curative. For severe but non-crisis PHPT-AP (such as our index case with peak calcium 3.54 mmol/L), definitive parathyroidectomy should be scheduled during the same hospitalization or within 2-4 weeks after pancreatitis resolution. Among 99 survivors, 75 had explicit follow-up records with no pancreatitis recurrence reported; quantifiable follow-up duration was available for 36 of these patients (median 18 months, IQR 6-36).
OBJECTIVES:The incidence of early-onset pancreatic cancer is increasing worldwide. This study aimed to evaluate whether survival differences between early and late-onset pancreatic cancer persist after adjustment for tumor characteristics, stage at diagnosis, and treatment, including within stage and treatment-specific subgroups. METHODS:This retrospective SEER cohort study included patients with pancreatic adenocarcinoma diagnosed between 2004 and 2020, with survival follow-up through 2022. Multivariable Cox regression analyses were performed to evaluate overall survival (OS) and cancer-specific survival (CSS) according to age group. RESULTS:Among 131,839 patients, 6,366 (4.8%) had early-onset pancreatic cancer and 125,473 (95.2%) had late-onset pancreatic cancer. The median OS was 9 months for EOPC and 6 months for LOPC, while the median CSS was 10 months for EOPC and 6 months for LOPC. Adjusted OS and CSS remained worse in patients with LOPC, with consistent findings across all stages. Among patients who underwent surgery or received chemotherapy, LOPC was associated with poorer outcomes. There was no survival difference in patients with early-onset and late-onset pancreatic cancer among those who received radiation therapy. CONCLUSIONS:This study demonstrated better overall survival and cancer-specific survival among EOPC after adjustment for clinical covariates including stage at diagnosis and treatment receipt, and histologic variables. The findings suggest that other factors beyond the available variables may contribute to better survival observed in younger patients. However, because information on chemotherapy regimens, treatment completion, and performance status was unavailable in the SEER database, residual confounding affecting survival outcomes cannot be excluded, and the findings should therefore be interpreted with caution.
BACKGROUND AND AIMS:Endoscopic ultrasound (EUS) can detect pre-malignant lesions in pancreas. Despite advances in training, EUS remains an operator dependent procedure and interval pancreatic cancer (PC) can be diagnosed after a preceding cancer-negative EUS. We aim to study outcomes of PC occurring after a EUS negative for cancer. METHODS:We utilized the TriNetX multi-institutional database to assess patients with PC and a preceding EUS. Patients whose EUS occurred less than 6 months before PC diagnosis were categorized as detected pancreatic cancer (D-PC), while those with EUS that did not detect PC between 6 and 18 months before PC diagnosis were categorized as post EUS-pancreatic cancer (PEPC). Propensity matched cohort analysis was performed after controlling for covariates to assess surgery, chemotherapy, hospitalization and all-cause mortality. RESULTS:Out of 20,828 included PC patients, 5.4% (n=1,127 ) were PEPC and 94.6% (n=19,701) were D-PC. At three years, PEPC cohort had significantly lower chemotherapy utilization (33.07% vs. 45.46%), surgery (9.53% vs 22.37%), all cause hospitalization (53.57% vs 69.70%) and all-cause mortality (27.90% vs. 33.42%) compared to D-PC. Predictors of mortality in PEPC cohort include White race (aHR 1.191), type 2 diabetes mellitus (aHR 1.144), nicotine use (aHR 1.233), location in head (aHR 1.319) and body (aHR 1.225) of pancreas. CONCLUSIONS:Nearly 5.4% pancreatic cancer occur after negative EUS in the previous 6-18 months. D-PC had higher chance of surgical resection and chemotherapy but also higher rates of mortality at 3-years. Further large scale studies with patient and procedure level data assessment to allow root-cause analysis is needed to determine its etiology and associated factors to limit its incidence.
BACKGROUND:Graduate medical education trainees increasingly use artificial intelligence tools without formal training. This study quantifies the gap between artificial intelligence exposure and readiness and examines attitudes, preferences, and barriers to guide curriculum development. METHODS:In 2025, a 4-week cross-sectional survey, consisting of 5-point Likert scale questions, of graduate medical education trainees at a single academic medical center assessed artificial intelligence familiarity, confidence, attitudes, curriculum preferences, and barriers to training. Descriptive statistics, χ2 tests, Spearman correlations, Jaccard similarity analysis, and network analysis characterized response patterns. RESULTS:Of 149 eligible trainees, 69 (48.3%) responded. Of all respondents, 85.5% (n = 59) reported active artificial intelligence tool use, and 2.9% (n = 2) had received formal artificial intelligence instruction. Median familiarity (3 [interquartile range, 3-4]/5) exceeded median confidence (3 [interquartile range, 2-3]/5) (P = .02), with 38.5% of high-familiarity trainees reporting low confidence. Trainees uniformly preferred postgraduate year-1 introduction (65.2%) and longitudinal curricula (62.3%), with no differences by training level or specialty. Barrier co-occurrence analysis revealed institutional support and faculty expertise deficits clustered strongly (Jaccard = 0.74). Network analysis identified efficiency beliefs as the central attitudinal hub. CONCLUSION:Graduate medical education trainees demonstrated high artificial intelligence exposure but low confidence, with formal training being rare. The familiarity-confidence gap suggests that passive exposure does not confer confidence. Uniform curricular preferences support standardized, cross-specialty implementation. Addressing institutional support and faculty expertise together, while separately targeting time constraints, may optimize artificial intelligence curriculum adoption.
BACKGROUND:Integrinβ4 (ITGB4), a transmembrane adhesion molecule, is closely associated with chemotherapy resistance in tumor cells. The pentose phosphate pathway (PPP) is a critical metabolic pathway that enables tumor cells to cope with chemotherapeutic stress and maintain survival. However, the specific mechanisms of ITGB4 regulating the PPP to influence the sensitivity of pancreatic adenocarcinoma (PAAD) to gemcitabine (GEM) remain unclear. METHODS:Data from the TCGA-PAAD dataset were utilized to assess ITGB4 expression level and its correlation with patient prognosis. The correlation between ITGB4 and the expression of key PPP genes was assessed. RT-qPCR and Western blot were employed to measure levels of ITGB4 and G6PD. The half-maximal inhibitory concentration (IC50) of GEM in cells and cell vitality were determined using the CCK-8 assay. Cell proliferation capacity was examined via the EdU assay. Glucose consumption, lactate production, and intracellular levels of NADP⁺ and NADPH were measured using specific kits to evaluate PPP metabolic activity. Intracellular reactive oxygen species (ROS) levels were detected by flow cytometry to analyze changes in the redox state. RESULTS:The high expression status of ITGB4 in PAAD was significantly linked with poor prognosis in patients, and its expression level was also positively correlated with the expression of PPP key genes. Based on functional experiment, knocking down the expression of ITGB4 significantly enhanced the sensitivity of PAAD cells to GEM. At the same time, knocking down ITGB4 resulted in significantly elevated intracellular NADPH levels and ROS levels, suggesting that the PPP pathway may be suppressed. In addition, upon 6-AN treatment, the increase in IC50 value and cell proliferation enhancement caused by overexpression of ITGB4 in GEM were reversed. CONCLUSION:ITGB4 reduces the sensitivity of PAAD cells to GEM by activating the PPP. This finding not only elucidates the mechanism of ITGB4 in PAAD chemo-resistance but also offers a theoretical basis for improving the efficacy of GEM treatment and developing targeted therapeutic strategies.
OBJECTIVES:Acute pancreatitis (AP) has heterogeneous trajectories: some patients deteriorate rapidly and require ICU care, whereas others develop delayed sequelae such as exocrine pancreatic dysfunction (EPD) and pancreatogenic diabetes. Existing scoring systems are burdensome, not available at first presentation, and poorly suited for forecasting longer-term outcomes. METHODS:Our AI platform operating exclusively on routinely collected EHR predict three outcomes after a first recorded AP diagnosis: (i) ICU admission (same-day, within 1 wk, within 2 wk), (ii) incident EPD, and (iii) incident insulin dependence among patients without prior diabetes diagnosis or anti-hyperglycemic prescriptions. Models were trained and validated using a U.S. administrative claims database comprising 164 million individuals. RESULTS:We demonstrate Area Under the Receiver-operating curve (AUC) of 0.986 (same-day ICU), 0.933 (ICU within 1 wk), and 0.927 (ICU within 2 wk). For longer-term outcomes, AUCs were 0.913 (male) and 0.901 (female) for incident EPD, and 0.861 (male) and 0.884 (female) for incident insulin dependence. Established chronic pancreatitis risk factors (e.g., obesity, tobacco dependence) are recovered with large effect sizes and high significance, supporting epidemiologic plausibility. Negative associations were consistent with etiologic subtypes, competing risks, and healthcare utilization patterns. CONCLUSIONS:Using only existing coded longitudinal history from a U.S. administrative claims environment,, ZeBRA enables simultaneous, test-free prediction of early deterioration and delayed pancreatic sequelae after AP, providing a scalable and interpretable basis for early risk stratification and targeted follow-up across the AP-chronic pancreatitis continuum. Broader clinical adoption will require external validation, especially in non-U.S. health systems and datasets with different coding and care-delivery structures.
OBJECTIVES:Oxidative stress (OS) plays a central role in triggering proinflammatory cascades in Acute Pancreatitis (AP). Evidence supports that antioxidant status is a key determinant of severity in human AP. Our study evaluates the plasma antioxidant capacity in patients admitted with AP and its relationship with disease severity. METHODS:Prospective recruitment of patients hospitalized for AP. Clinical and demographic data were recorded. Blood samples were obtained at 24, 48, and 72 hours after admission. Total antioxidant capability was assessed using ferric reducing antioxidant power (FRAP), ABTS radical scavenging capacity, and catalase activity. AP severity was classified according to the Revised Atlanta Classification. RESULTS:A total of 91 patients were studied, 75 suffered from a mild episode of AP (MAP), and 16 developed moderately-severe/severe AP (MSAP-SAP). FRAP levels were significantly lower at 24, 48, and 72 hours in MSAP-SAP patients compared with those with MAP. Catalase activity on admission was significantly higher in MAP patients than in MSAP-SAP patients. Multivariate logistic regression identified 2 predictive models for MSAP-SAP. A cut-off of 0.063 (AUC 0.81, 95% IC 0.669-0.947) in model 1 and a cut-off of 0.100 in model 2 (AUC 0.83, 95% IC 0.706-0.958) demonstrated good sensitivity and specificity in discriminating MSAP-SAP patients. CONCLUSIONS:Reduced plasma antioxidant levels in the early stages of AP are independently associated with greater disease severity and may serve as early prognostic biomarkers.
The adult chronic pancreatitis (CP) working group, formed at the inception of the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC), has developed a robust framework and infrastructure to conduct clinical, translational, and mechanistic studies of CP. At its core is PRO spective Evaluation of C hronic Pancreatitis for E pid E miologic and Translational Stu D ies (PROCEED), the first longitudinal cohort study of CP in US adults, launched in 2017. PROCEED has developed a well-annotated clinical data set of over 2000 deeply-phenotyped participants, a biorepository and an imaging repository. Investigators have published promising data on blood-based and imaging-based biomarkers of CP diagnosis and pain, which are awaiting validation. Clinical observations include classification of patients into mechanism-based pain phenotypes using responses to PROMIS questionnaires, prevalence and predictors of opioid use, prevalence of psychological comorbidity, and osteopathy in CP patients. Pilot clinical trials have evaluated the effect of oral indomethacin on pancreatic fluid prostaglandin E2 levels and Internet-based cognitive behavioral therapy (CBT) for chronic pain. Results of pilot trials have led to an ongoing definitive randomized clinical trial for CBT. The rich environment and resources have facilitated mentorship and academic development of many early-stage investigators. Investigators outside of the consortium have opportunities for collaboration. In the next 5 years, the working group plans to further strengthen the research platform, complete primary and key secondary analyses of PROCEED and ancillary studies, continue efforts to develop biomarkers for diagnosis and prognosis of CP, and complete ongoing clinical trials to address unanswered questions in the field.
OBJECTIVES:The Japan Pancreatic Cancer Registry (JPCR), managed by the Japan Pancreas Society, has adopted the National Clinical Database (NCD) platform for data registration. This study aimed to describe the nationwide annual trends and clinical outcomes of pancreatic neoplasms using this NCD-based registry (NCD-JPCR) for the first time. METHODS:We analyzed data from the NCD-JPCR for pancreatic neoplasms registered between 2012 and 2018. The annual epidemiological trends and survival outcomes were evaluated for major pancreatic neoplasms, including invasive ductal carcinoma (IDC). RESULTS:In total, 47,005 patients were registered from 1,062 departments, with approximately 600 departments contributing annually. IDC was the most common diagnosis (n=36,204; 77.0%), followed by intraductal (n=4,498; 9.6%), cystic (n=2,687; 5.7%), and pancreatic neuroendocrine neoplasms (n=2,494; 5.3%). In the survival analysis of IDC, patients who underwent resection showed a significantly longer median overall survival (mOS) in 2015-2018 than in 2012-2014 (34.5 months [n=17,328] vs. 29.7 months [n=9,623]; P<0.0001). Similarly, mOS for patients who did not undergo resection significantly improved in 2015-2018 compared with 2012-2014 (10.2 months [n=5,733] vs. 9.0 months [n=3,326]; P<0.0001). CONCLUSIONS:Treatment outcomes for IDC showed significant improvements from the early to the late 2010s for both patients who did and did not undergo resection. These findings may reflect nationwide progress in the multidisciplinary management of pancreatic cancer in Japan.
BACKGROUND:The incidence of Ampullary carcinoma (AC) has dramatically increased. Nearly 50% of patients develop recurrence indicating need for additional prognostic markers and treatment options. Emerging evidence suggests that Mesenchymal Epithelial Transition (MET) genes play a role in tumorigenesis and can be a useful therapeutic target, however, its role in AC remains unexplored. METHODS:This study investigated the methylation status using methylation specific PCR, mRNA expression using quantitative PCR and protein expression using Immunohistochemistry of the MET proto-oncogene in 61 surgically resected AC specimens and further examined its co-expression with HER2. RESULTS:Our findings revealed MET promoter hypomethylation (68.85%), increased expression of MET at mRNA (67.21%) and protein level (54%) in ACs patients. Significant correlation was observed between both hypomethylation and increased mRNA expression (P=0.026; P<0.000), and MET mRNA and protein expression (P=0.037). Further, MET expression was notably higher in early stage (P=0.003) and Intestinal-type (84.21%) than Pancreatobiliary type (PB-type) (61.76%) (P=0.199). Additionally, co-expression of MET and HER2 receptors occurred in a significant subset of cases in AC suggesting receptor tyrosine kinase convergence (P=0.014). In silico analysis of the GSE60979, dataset corroborated these findings, showing increased MET and ERBB2 (HER2) expression in tumor samples compared to normal tissues. At a median follow-up of 34 months the mean survival of AC patient was 37.3±2.5 months. CONCLUSIONS:These findings demonstrate that MET dysregulation is a recurrent molecular event in ampullary carcinoma and support further investigation of MET and HER2 co-expression as a basis for future mechanistic and therapeutic studies.
BACKGROUND:Lifestyle is a key modifiable determinant of acute pancreatitis (AP) occurrence and recurrence. However, comprehensive lifestyle patterns and their psychosocial correlates in patients with AP remain insufficiently explored. OBJECTIVE:To evaluate lifestyle status using a Healthy Lifestyle Index (HLI) and to examine its associations with personality traits and social support in patients with AP. METHODS:In this cross-sectional study, 368 hospitalized patients with AP were enrolled from July 2021 to June 2023 at a tertiary hospital. The HLI was constructed based on 5 modifiable factors: body mass index, smoking, alcohol consumption, physical activity, and diet (score range 0-5). Personality traits were assessed using the Chinese Big Five Personality Inventory-Brief Version, and social support was measured using the Social Support Rating Scale. An ordered multivariable logistic regression was performed to identify factors independently associated with HLI levels. RESULTS:The mean HLI score was 2.66±0.95, and only 18.7% of patients achieved a high HLI (4-5 points). In model 1, female sex (OR=7.2, 95% CI: 4.5-11.8), older age (OR=1.0, 95% CI: 1.0-1.0), and conscientiousness (OR=1.0, 95% CI: 1.0-1.0) were positively associated with higher HLI levels, whereas hypertriglyceridemia (OR=0.4, 95% CI: 0.2-0.7) and extraversion (OR=0.9, 95% CI: 0.9-0.9) were inversely associated. In model 2, female sex (OR=6.2, 95% CI: 3.9-10.1), conscientiousness (OR=1.0, 95% CI: 1.0-1.1), and social support (OR=1.0, 95% CI: 1.0-1.0) remained positively associated with HLI, while extraversion (OR=0.9, 95% CI: 0.9-0.9) and bedtime after 24:00 (OR=0.6, 95% CI: 0.3-0.9) were associated with lower HLI levels. CONCLUSIONS:Lifestyle health among patients with AP was suboptimal. Sociodemographic factors, metabolic conditions, personality traits, and social support were independently associated with lifestyle patterns. These findings support the integration of psychosocial assessment into lifestyle management strategies for AP.
OBJECTIVES:Pancreatic cancer has poor prognosis, and incidence is rising, particularly in high Socio-Demographic Index (SDI) countries. This study examines trends in pancreatic cancer incidence, prevalence, and mortality in the United States and high-SDI countries from 1991 to 2021 and uses modeling to project pancreatic cancer rates through 2041. METHODS:This retrospective, population-based observational study analyzed pancreatic cancer trends using the Global Burden of Disease (GBD) database. Primary outcome measures included age-standardized incidence (ASIR), prevalence (ASPR), and mortality (ASMR) rates, stratified by sex and region. Joinpoint regression analysis estimated annual percentage change (APC) with 95% CIs to identify significant trends. Autoregressive Integrated Moving Average (ARIMA) models were used to forecast rates from 2022 to 2041. RESULTS:From 1991 to 2021, pancreatic cancer ASIR, ASPR, and ASMR rose in both the United States and high-SDI countries, with a sharp rise after 2001 and a plateau after 2016. ASIR peaked at 10.46 (United States, 2016) and 10.24 (high SDI, 2018), with similar trends in ASPR and ASMR. APC analysis revealed a significant rise ( p <0.001) in most periods through 2016, although rates recently declined between 2016 and 2020. Males consistently had higher rates compared with females. Projections of ASMR to 2041 continue to rise to 9.856 in high-SDI countries and 9.813 in the United States, leading to a projected 271,310 and 72,304 deaths, respectively. CONCLUSIONS:Pancreatic cancer incidence, prevalence, and mortality have increased in the past 2 decades in both high-SDI countries and the United States. Rising incidence and prevalence are likely driven by a combination of improved diagnosis and treatment, as well as population aging, lifestyle, and environmental factors. Males have higher rates compared with females across both regions, a trend that has not yet been fully explained. Despite the recent stabilization of pancreatic cancer rates, modeling predicts a rise in all 3 metrics through 2041. Continued efforts are imperative to refine early diagnostic methods, identify modifiable risk factors, and develop effective interventions to reduce mortality.
