Pancreatic cancer epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahad Hasan, M.D.[2]

Overview

Pancreatic cancer is uncommon compared with other solid tumors but is extremely lethal. It is currently the third leading cause of cancer death in the United States and is projected to become the second by about 2030.[1][2] About 90% of cases are pancreatic ductal adenocarcinoma (PDAC), so population statistics for pancreatic cancer largely reflect PDAC.[2] In 2021, U.S. age-adjusted incidence was 18.7 per 100,000 and mortality was 15.8 per 100,000. These two rates are nearly the same, which reflects how poor the prognosis is.[3] Five-year relative survival has risen from about 4% in 2000 to about 13%, but this is still among the lowest of any major cancer.[4]

Incidence rises steeply after age 50 and is higher in men and in non-Hispanic Black individuals. Rates are highest in very-high Human Development Index (HDI) regions. Early-onset disease (diagnosis before age 50) is increasing in the U.S., mainly among women.[1][5][6]

Epidemiology and Demographics

Burden in the United States

Measure Estimate
Age-adjusted incidence (2021) 18.7 per 100,000; 55,643 new diagnoses[3]
Age-adjusted mortality (2021) 15.8 per 100,000; 47,906 deaths[3]
Annual estimates (American Cancer Society–based) About 62,000 new cases and 48,000–49,000 deaths[1]
Lifetime risk About 1.7% by age 75[1]
Incidence trend Rising about 0.5% per year since 2010[1]
Rank among causes of cancer death 3rd; projected to be 2nd (after lung cancer) by about 2030[1][2]

Histologic Distribution

Survival and Stage at Diagnosis

  • Overall 5-year relative survival has improved from about 4% (2000) to about 13%.[4]
  • Only 15–20% of patients have surgically resectable disease when diagnosed. This late presentation is the main reason overall survival is poor.[4][1]
  • Stage I disease can reach about 80% 5-year survival, so the stage at detection is the strongest population-level survival lever.[7][1]
Stage distribution and 5-year relative survival (U.S., SEER summary stage)
SEER summary stage Proportion at diagnosis 5-year relative survival
Localized About 17% About 37–44%
Regional About 26% About 12%
Distant About 46% About 3%
Unstaged About 10% —

Sources: Roth et al., 2026; Stoffel et al., 2023; Aslanian et al., 2020.[4][1][7]

Age

  • Age is the strongest demographic risk factor. Age-specific incidence climbs steeply after age 50 and peaks at 70–79 years.[4]
  • Mean age at diagnosis is about 65–71 years. Only about 20% of cases are diagnosed before age 60.[1][8]

Sex

  • Incidence and mortality are consistently higher in men. The global male-to-female incidence ratio is about 1.3–1.4:1, and this excess is not fully explained.[5][9]
  • Worldwide age-standardized rates in 2022:[4]
    • Incidence: 5.5 per 100,000 in men vs. 4.0 per 100,000 in women
    • Mortality: 5.0 per 100,000 in men vs. 3.5 per 100,000 in women

Race and Ethnicity (United States)

Age-adjusted incidence by race/ethnicity[1]
Group Incidence (per 100,000)
Non-Hispanic Black 15.9
Non-Hispanic White 13.4
Hispanic 12.2
Asian/Pacific Islander 10.3
  • Non-Hispanic Black individuals have the highest incidence and mortality of all major U.S. racial/ethnic groups.[1]
  • In SEER data, median overall survival is 5 months for Black patients and 6 months for White patients. Black race remains linked to worse overall survival after propensity-score matching (HR about 1.16).[10]
  • Lower rates of surgery (about 14% vs. 17%) and longer time to treatment explain only part of this gap. About 56% of the disparity remains unexplained after accounting for surgery and income.[10] Black patients also have worse survival than White patients within the same income level.[11]
  • Five-year relative survival improved in all groups between 2002–2006 and 2015–2019. For example, it rose from 6.3% to 12.5% in non-Hispanic White patients and from 5.0% to 10.5% in non-Hispanic Black patients. The Black–White gap has not closed.[12]

Global Burden and Geographic Variation

  • GLOBOCAN 2022 estimated 510,992 new cases and 467,409 deaths worldwide. Pancreatic cancer ranks about 12th in incidence but 6th–7th in cancer mortality because most cases are fatal.[13][4][14]
  • Incidence and mortality are about 5-fold higher in very-high-HDI/sociodemographic index (SDI) countries than in low-resource settings. Western Europe (about 8.5 per 100,000) and North America (about 8.0 per 100,000) have the highest rates, compared with about 1.3 per 100,000 in Southeast Asia.[1][5]
  • Global lifetime risk is about 0.89%. It ranges from about 0.15% in Middle Africa to about 2.06% in Western Europe.[14]
  • Between 1990 and 2021, global incident cases more than doubled, reaching about 509,000 in 2021. This rise is mainly driven by population aging and growth. Over the same period, the age-standardized incidence rate rose only slightly, from 5.47 to 5.96 per 100,000.[15][16]

Early-Onset Pancreatic Cancer

  • Early-onset pancreatic cancer (EOPC) is usually defined as diagnosis before age 50, although some studies use cutoffs of 55 or 60 years.[6]
  • U.S. EOPC incidence rose from 1.1 to 1.4 per 100,000 between 2013 and 2022 (average annual percent change [AAPC] 2.4%). In 2022, SEER recorded 1,324 EOPC cases, about 5.2% of all pancreatic cancers.[6][17]
  • Sex: The increase is mostly in women, whose rate rose from 1.0 to 1.4 per 100,000 (AAPC 2.8%). In men, the rate rose from 1.3 to 1.4 per 100,000 (AAPC 1.0%).[6][17]
  • Race/ethnicity: EOPC incidence is highest in non-Hispanic Black individuals (about 1.7 per 100,000). The largest relative increases have been in Hispanic individuals (AAPC 4.6%) and non-Hispanic White individuals.[6][17]

Population-Attributable Burden

  • The rising burden reflects population aging plus a growing prevalence of modifiable risk factors. Details are covered in the risk factors microchapter.
  • Cigarette smoking is the leading modifiable risk factor and accounts for about 21% of pancreatic cancer deaths.[14]
  • Excess body weight accounts for about 17% of U.S. cases (population-attributable fraction).[18]
  • In the U.S. and other high-SDI settings, age-standardized rates rose sharply after 2001 and leveled off after about 2016. Some analyses show slight recent declines. Absolute numbers of cases and deaths keep rising as the population ages.[9]
  • Globally, GLOBOCAN-based models project that pancreatic cancer incidence will rise about 95% by 2050. This is the largest relative increase among gastrointestinal cancers, with the fastest growth in low- and medium-HDI countries.<ref name="Danpanichkul2026">Danpanichkul P, et al. Projected global burden of gastrointestinal cancers to 2050. Cancer. 2026.

Areas of Uncertainty

  • The cause of the higher rates in men is still unexplained. Hormonal, behavioral, and biological hypotheses have not been proven.[5]
  • EOPC trends differ by data source. SEER/registry data show a rising U.S. incidence, while some Global Burden of Disease (GBD) analyses show stable or declining global age-standardized early-onset rates. This difference is partly a method artifact from grouping PDAC with neuroendocrine tumors.
  • Projection models disagree. Some forecast continued rises in age-standardized incidence and mortality through 2040–2050. Some GBD-based Bayesian models project declining age-standardized rates even as absolute counts rise.[16][19]
  • It is not yet known how much of the racial survival disparity comes from tumor biology versus access to care.[10]

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Stoffel EM, Brand RE, Goggins M (2023). "Pancreatic cancer: changing epidemiology and new approaches to risk assessment, early detection, and prevention". Gastroenterology. 164 (5): 752–765. doi:10.1053/j.gastro.2023.02.012. PMID 36804602 Check |pmid= value (help).
  2. ↑ 2.0 2.1 2.2 2.3 Park W, Chawla A, O'Reilly EM (2021). "Pancreatic cancer: a review". JAMA. 326 (9): 851–862. doi:10.1001/jama.2021.13027. PMID 34547082 Check |pmid= value (help).
  3. ↑ 3.0 3.1 3.2 Peery AF, Murphy CC, Anderson C; et al. (2025). "Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2024". Gastroenterology. 168 (5): 1000–1024. doi:10.1053/j.gastro.2024.12.029.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Roth S, Apte M, Balachandran VP; et al. (2026). "Pancreatic cancer". Nat Rev Dis Primers.
  5. ↑ 5.0 5.1 5.2 5.3 Huang J, Lok V, Ngai CH; et al. (2021). "Worldwide burden of, risk factors for, and trends in pancreatic cancer". Gastroenterology. 160 (3): 744–754. doi:10.1053/j.gastro.2020.10.007. PMID 33058868 Check |pmid= value (help).
  6. ↑ 6.0 6.1 6.2 6.3 6.4 Jayakrishnan T, Ng K (2025). "Early-onset gastrointestinal cancers: a review". JAMA. doi:10.1001/jama.2025.10218.
  7. ↑ 7.0 7.1 Aslanian HR, Lee JH, Canto MI (2020). "AGA clinical practice update on pancreas cancer screening in high-risk individuals: expert review". Gastroenterology. 159 (1): 358–362. doi:10.1053/j.gastro.2020.03.088. PMID 32416142 Check |pmid= value (help).
  8. ↑ Mizrahi JD, Surana R, Valle JW, Shroff RT (2020). "Pancreatic cancer". Lancet. 395 (10242): 2008–2020. doi:10.1016/S0140-6736(20)30974-0. PMID 32593337 Check |pmid= value (help).
  9. ↑ 9.0 9.1 Shouse et al. Pancreatic cancer epidemiologic trends. Pancreas. 2026.
  10. ↑ 10.0 10.1 10.2 Dhali et al. Racial disparities in pancreatic cancer survival (SEER analysis). Am J Clin Oncol. 2026.
  11. ↑ Wu et al. Racial and socioeconomic disparities in pancreatic cancer survival. Am J Surg. 2026.
  12. ↑ Chen et al. Trends in 5-year cancer survival disparities by race and ethnicity in the US between 2002–2006 and 2015–2019. Sci Rep. 2024.
  13. ↑ Bray F, Laversanne M, Sung H; et al. (2024). "Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA Cancer J Clin. 74 (3): 229–263. doi:10.3322/caac.21834. PMID 38572751 Check |pmid= value (help).
  14. ↑ 14.0 14.1 14.2 Stoop TF, Javed AA, Oba A; et al. (2025). "Pancreatic cancer". Lancet. 405 (10485): 1182–1202. doi:10.1016/S0140-6736(25)00261-2. PMID 40187844 Check |pmid= value (help).
  15. ↑ Yu W, Zhou D, Meng F; et al. (2025). "The global, regional burden of pancreatic cancer and its attributable risk factors from 1990 to 2021". BMC Cancer. 25: 186. doi:10.1186/s12885-025-13471-y.
  16. ↑ 16.0 16.1 Li T, Lin C, Wang W (2025). "Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021". BMC Cancer. 25 (1). doi:10.1186/s12885-025-13597-z.
  17. ↑ 17.0 17.1 17.2 Surveillance, Epidemiology, and End Results Program. SEER*Explorer: an interactive website for SEER cancer statistics. Surveillance Research Program, National Cancer Institute; April 16, 2025. Accessed May 19, 2025. SEER*Explorer
  18. ↑ Islami et al. Population-attributable fractions of cancer due to excess body weight. Nat Rev Clin Oncol. 2020.
  19. ↑ Invalid <ref> tag; no text was provided for refs named Danpanichkul2026
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