IDDF2024-ABS-0356 The burden of early-onset pancreatic cancer and its risk factors: the India perspective from the global burden of disease study 2021

<h3>Background</h3> Pancreatic cancer (PC) poses a significant global health challenge. The Global Burden of Disease (GBD) data reveals a rising trend in early-onset PC (EOPC) globally. India is experiencing an increase in non-communicable disease burden, with a 5-year prevalence of PC of 8453/100,000 individuals in 2021. However, the burden of EOPC in India remains uninvestigated. <h3>Methods</h3> EOPC was defined as PC diagnosed in individuals aged 15-49 years. The GBD India Compare tool (1990-2021) was queried for ‘pancreatic cancer’ as the ‘cause’ and ‘incidence,’ ‘deaths,’ and ‘DALYs’ as the ‘measure’ for the 15-49 years age group. The national and state-wise burden of EOPC in India was determined, and the Human Development Index (HDI) was used to evaluate associations between human development and EOPC burden. The EOPC burden attributable to risk factors such as smoking, high body mass index (BMI), and high fasting plasma glucose (FPG) was also estimated. <h3>Results</h3> From 1990 to 2021, national EOPC incidence, mortality, and DALY rates increased significantly, with Gujarat, Kerala, and Tamil Nadu showing the highest percentage increases in overall EOPC burden (IDDF2024-ABS-0356 Figure 1. Change in early-onset pancreatic cancer burden in India). In 2021, EOPC incidence was highest in Kerala, Arunachal Pradesh, and Mizoram (IDDF2024-ABS-0356 Figure 2. Early-onset pancreatic cancer burden in India in 2021). The EOPC burden increased with increasing HDI up to a high level, after which it decreased at very high HDI levels, although it remained higher than that at medium HDI levels (IDDF2024-ABS-0356 Figure 3. Early-onset pancreatic cancer burden in India by human development index). This contrasts with global trends, which showed a consistent increase in EOPC burden with rising sociodemographic index levels. Similar to global trends, DALYs attributable to smoking decreased, while those attributable to high BMI and high FPG increased from 1990 to 2021 (IDDF2024-ABS-0356 Figure 4. Trends of early-onset pancreatic cancer burden attributable to risk factors in India). <h3>Conclusions</h3> The EOPC burden is increasing in India, particularly in high HDI regions, which are driven by lifestyle and metabolic risk factors. The findings underscore the need for greater awareness and targeted interventions to address this growing health concern.