Pancreatic cancer in Pakistan: a lens into the research landscape

Objective: To identify and categorise the types of research conducted on pancreatic cancer in Pakistan, to analyse gaps in the knowledge and focus areas within the existing research, and to prioritise research areas requiring immediate attention to improve patient care. Method: The scoping review comprised literature search on PubMed, ScienceDirect, GoogleScholar and PakMedinet databases for research on pancreatic cancer done in the Pakistani population and published between January 1, 1998, and December 1, 2021. Key words included ‘pancreatic neoplasms’, ‘pancreatic cancer’, ‘Pakistan’ and their medical subject heading derivatives. Data about type of study, research methodology, geospatial location of the study site, date of publication and level of evidence was extracted by two independent evaluators. Cancer-specific variables included tumour location and histology. Interventions studied were grouped into surgical resections, systemic therapeutics and diagnostic modalities. Results: Of 3,120 studies identified, 84(0.02%) were analysed. The most common study types were descriptive studies 25(30%), case reports 19(23%) and retrospective cohorts 11(13%). The trend of research showed an overall increase from 2-4 articles per annum in 2011-13 to 14 in 2021. The most studied neoplasm was located in the pancreatic head 32(38%), followed by neoplasms of the periampullary region 24(29%). Most studies were on surgical intervention 42(50%), followed by adjuvant and neoadjuvant chemotherapy 8(10%). Conclusion: There was found to be little data about pancreatic cancer in Pakistan along all aspects of the disease process, including mechanistic, epidemiological, treatment, or outcome elements. Most research was found to be focussed on surgical care and short-term outcomes. Key Words: Pancreatic neoplasms, Pancreatic cancer, Pakistan, Epidemiology, Health research priorities, Disease burden, Surgical outcomes, Chemotherapy, Low-and-middle income countries, LMICs.