Objective To analyze the trend in the burden of pancreatic cancer among Chinese residents from 1990 to 2021, providing reference data for the prevention and control of pancreatic cancer in China.

Methods Data related to the burden of pancreatic cancer among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease (GBD 2021) database. Standardized incidence rates, standardized mortality rates, and disability-adjusted life years (DALYs) were extracted for descriptive analysis. The Joinpoint regression model was used to analyze trends in the burden of pancreatic cancer, and the age-period-cohort (APC) model was applied to assess the effects of age, period, and birth cohort on the burden of pancreatic cancer.

Results The age-standardized incidence rate of pancreatic cancer in China′s overall, male, and female populations increased from 4.54/100 000, 5.55/100 000, and 3.64/100 000 in 1990 to 5.64/100 000, 7.29/100 000, and 4.18/100 000 in 2021, respectively. The average annual percentage changes (AAPCs) were 0.72%, 0.89%, and 0.48%, respectively, with statistically significant increasing trends for the overall, male, and female populations (all P<0.001). The age-standardized mortality rates increased from 4.83/100 000, 5.91/100 000, and 3.90/100 000 in 1990 to 5.72/100 000, 7.37/100 000, and 4.29/100 000 in 2021, respectively, with AAPCs of 0.56%, 0.55%, and 0.33%, respectively. Statistically significant increasing trends were observed for the overall, male, and female populations (all P<0.001). The age-standardized disability-adjusted life years (DALYs) rates increased from 123.16/100 000, 151.33/100 000, and 95.37/100 000 in 1990 to 137.23/100 000, 179.36/100 000, and 96.89/100 000 in 2021, respectively, with AAPCs of 0.36%, 0.55%, and 0.07%, respectively. Statistically significant increasing trends were observed for the overall and male populations (all P<0.001). The risk of pancreatic cancer incidence increased with age for both males and females. The age effect coefficients were lowest for the 15-19 age group (-3.638 and -3.406, respectively), highest for males in the 85-89 age group (1.623), and highest for females in the 80-84 age group (1.582). The risk of pancreatic cancer incidence increased over time, with period effect coefficients increasing from -0.477 and -0.388 in 1992-1996 to 0.488 and 0.382 in 2017-2021 for males and females, respectively. The risk of pancreatic cancer incidence decreased with birth cohort, with the lowest cohort effect coefficients observed in 2002-2006 (-1.719 and -1.877 for males and females, respectively) and the highest in 1897-1901 (1.374 and 1.504, respectively). The risk of pancreatic cancer mortality generally increased with age for both males and females. The age effect coefficients were lowest for the 15-19 age group (-3.658 and -3.428, respectively), highest for males in the 90-94 age group (1.751), and highest for females in both the 80-84 and 85-89 age groups (1.686 for both). The risk of pancreatic cancer mortality increased over time, with period effect coefficients increasing from -0.465 and -0.384 in 1992-1996 to 0.477 and 0.366 in 2017-2021 for males and females, respectively. The risk of pancreatic cancer mortality decreased with birth cohort, with the lowest cohort effect coefficients in 2002-2006 (-1.794 and -1.964 for males and females, respectively) and the highest in 1897-1901 (1.456 and 1.594, respectively). The risk of pancreatic cancer burden generally increased with age for both males and females. The age effect coefficients were lowest for the 15-19 age group (-3.069 and -2.834, respectively) and highest for the 70-74 age group (1.049 and 1.286 for males and females, respectively). The risk increased over time, with period effect coefficients increasing from -0.358 and -0.252 in 1992-1996 to 0.364 and 0.260 in 2017-2021 for males and females, respectively. The risk of pancreatic cancer burden decreased with birth cohort, with the lowest cohort effect coefficients in 2002-2006 (-1.334 and -1.513 for males and females, respectively) and the highest in 1897-1901 (1.000 and 1.114, respectively).

Conclusion From 1990 to 2021, the age-standardized incidence, mortality, and DALY rates of pancreatic cancer in the Chinese population, as well as the age-standardized DALY rate in males, showed an increasing trend. The risk of pancreatic cancer burden increased with age and period but decreased with birth cohort.