Pancreatic cancer survival in central and northern Denmark from 1998 through 2009: A population based cohort study

Abstract

Objectives: Pancreatic cancer has a relatively low incidence but ranks fourth amongcancer-related deaths in western countries. In Denmark, cancer survival generally is lower thanin other countries with comparable health care systems. As a result, in 2000, a national strategyto improve cancer survival was introduced. Here we examine time trends in survival and relativemortality among pancreatic cancer patients, using Danish population and medical databases.Methods: Using the Danish National Patient Registry (DNPR), we identified all incident pancreaticcancer patients (n = 2968) diagnosed between 1998 and 2009 in the Central and NorthDenmark Regions. We computed the 1-, 3-, and 5-year survival and relative mortality (MRR)and associated 95% confidence intervals (CI) adjusting for age and gender. Among surgicalpatients, we also computed 30-day mortality and 30-day MRR.Results: Median age at diagnosis was approximately 71 years. The annual number of patientsincreased from 189 in 1998-2000 to 302 in 2007-2009. There was a slight improvement in 1-, 3-, and 5-year survival over time from 14.8% to 17.7%; 3.5% to a predicted 5.6%; and from2.0% to a predicted 3.8%, from 1998-2000 to 2007-2009, respectively. Correspondingly, theadjusted relative mortality decreased from 1998-2000 to 2007-2009. Thirty-day post-operativemortality decreased from 12.2% in 1998-2000 to 5.8% in 2007-2009, corresponding to a 30-dayMRR of 0.38, 95% CI = 0.09, 1.6 in 2007-2009.Conclusion: There was a slight, albeit modest, improvement in survival and relative mortalityin pancreatic cancer patients between 1998 and 2009. As we lacked staging information,it is not clear if this improvement is attributable to earlier stage at diagnosis. However, theseimprovements likely reflect the national cancer strategy which aimed to centralize cancerservices and involved the introduction of palliative and adjuvant chemotherapy for pancreaticcancer in Denmark. The dismal prognosis of pancreatic cancer means that efforts to improvesurvival need to be intensified. © 2011 Cronin-Fenton et al, publisher and licensee Dove Medical Press Ltd.