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Pancreatic cancer: gradual rise, increasing relevance

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Pancreatic cancer is likely to become one of the leading causes of cancer death in Australia

Pancreatic cancer is the 10th most frequently occurring cancer but the fifth most common cause of cancer death in Australia, as is also seen in other developed regions of the world.1 A gradual increase in incidence has been observed since the 1980s in almost all age groups in both sexes in Australia (Box 1).3 Increases have been attributed only to trends in smoking, which is considered causal,4 with local published data suggesting a lag of about 30 years between smoking trends and incidence.5 However, overweight and obesity may also have contributed, in part, to incidence trends.6

In Australia (and other developed countries), only about 50%–70% of cases of pancreatic cancer are histologically confirmed based on review of the primary tumour,1 because pancreatic biopsy procedures have been associated with significant risks7 and are often avoided. But improvements in imaging modalities, particularly endoscopic ultrasound and pancreas-specific computed tomography, and magnetic resonance imaging protocols, together with endoscopically guided biopsy procedures, are likely to…