The current state of pancreatic cancer in Canada: Incidence, mortality, and surgical therapy

Objective: This study aimed to evaluate the trends in the incidence, survival, and surgical therapy for Canadian patients affected by pancreatic cancer (PC). Methods: The incidence, mortality, number of resections, and outcomes of patients with PC stratified by year, sex, and province were extracted from Canadian cancer databases. Results: In 2012, PC was diagnosed in 4600 Canadians and it was responsible for 4300 deaths. The age-standardized incidence was 9 to 10 new cases per 100,000 individuals. The mortality rate remained the highest among all the solid tumors with a case-to-fatality ratio of 0.93. The age-standardized 5-year relative survival was 9.1% (95% confidence interval [CI], 8.3-10). There were geographic variations among provinces with the highest survival registered in Ontario (10.9%; 95% CI, 9.9-12) and the lowest survival reported in Nova Scotia (4.7%; 95% CI, 2.8-7.2). The percentage of patients who underwent surgery decreased from 19% (2006-2007) to 17% (2009-2010). Pancreatic resections were performed in high-volume centers in 74% of cases. In-hospital mortality was 5%, 93% of patients were discharged home, and 36% of patients required home support after discharge. Conclusions: Long-term outcomes of Canadian patients affected by PC remain unsatisfactory, with only 9% of the patients surviving at 5 years. Surgical therapy was performed only in 17% to 19% of patients.