Persistence of severe global inequalities in the burden of pancreatic cancer: a cross-sectional study

To assess the global burden and socioeconomic inequalities in the distribution of pancreatic cancer from 1990 to 2019. We investigated the temporal trend of pancreatic cancer burden using Average Annual Percent Change (AAPC) from joinpoint regression analysis, decomposed trends by demographic and epidemiological factors, quantified cross-national health inequalities, and evaluated quality of care using the Quality of Care Index (QCI). Analyses were conducted by age, sex, sociodemographic index across 204 countries/territories from 1990 to 2019 using Global Burden of Disease Study 2019 data. The global age-standardized rates of incidence, prevalence, disability-adjusted life years (DALYs), and mortality significantly increased from 1990 to 2019, with an AAPC of 0.78, 0.95, 0.63, and 0.73, respectively. Countries with High, High-middle, Middle, Low-middle, and Low Socio-demographic Index (SDI)had a decreasing burden of pancreatic cancer in that order. The absolute cross-national inequality (Slope of inequality index) has risen from 1990 to 2019, and relative inequality (concentration index) for global PC remained essentially constant between 1990 and 2019. The overall global QCI score had increased slightly from 38.68 in 1990 to 47.04 in 2019, and it was marginally better in females (QCI score 52.96) than in males (46.44). The highest QCI score was observed in High SDI quintile with a score of 69.74, while the Low SDI quintile displayed the lowest QCI with 22.61. Additionally, the quality of care of young-onset PC patients is alarming. There were wide disparities in the burden and care of pancreatic cancer across different SDI countries. Health policymakers should focus on these disparities and inequalities for appropriate policies and interventions.