Subnational trend and driving factors for pancreatic cancer burden in China, 1990–2021: an analysis based on the Global Burden of Disease Study 2021

The mortality of pancreatic cancer in China showed an increasing trend between 2005 and 2020, with significant discrepancies in the burden of pancreatic cancer in provinces. We analyzed numbers of death, incidence, disability-adjusted life years (DALY) and corresponding age-standardized rates for pancreatic cancer in China using data from the Global Burden of Disease Study 2021. We conducted trend analysis in pancreatic cancer burden over time by age group and gender. Decomposition analysis was used to assess the drivers of change in cancer-related deaths in China due to three explanatory factors: population growth, population ageing and age-specific mortality. In 2021, the ASMR of pancreatic cancer in China was 5.72/100,000(95%UI: 4.59, 6.91), the age-standardized incidence (ASIR) rate was 5.64/100,000(95%UI: 4.52, 6.84) and the age-standardized DALY rate was 137.23/100,000 (95%UI:108.15, 166.74). From 1990 to 2021, the ASMR of pancreatic cancer in China generally showed an increasing trend (AAPC: 0.56, 95%UI: 0.52, 0.59). The burden of pancreatic cancer was consistently higher in Chinese men compared to women during the study period.Compared with 1990, the number of deaths from pancreatic cancer has increased in all provinces of China in 2021, with the overall number of deaths increasing by 67.49%. Population ageing was the major cause of the increase in deaths from pancreatic cancer in China, accounting for 45.89%. The burden of pancreatic cancer in China is still at a high level and population ageing is the main reason for the increase in pancreatic cancer deaths.