The Epidemiology of Pancreatic Cancer and the Association With Acetylsalicylic Acid in the United States: A Population-Based Study

Pancreas. 2020 Oct;49(9):1207-1212. doi: 10.1097/MPA.0000000000001659.

Abstract

Objectives: Pancreatic cancer (PaC) is the third leading cause of cancer-related death in the United States. Multiple studies have investigated the epidemiology and the association between PaC and acetylsalicylic acid (ASA) use, revealing mixed results. Using a large database, we sought to investigate the epidemiology of PaC.

Methods: Using a commercial database (Explorys Inc, Cleveland, Ohio), which includes electronic health record data from 26 major integrated US health care systems, all patients 18 years and older diagnosed with PaC for 5 years were identified based on Systematized Nomenclature Of Medicine-Clinical Terms. We determined the prevalence of PaC and the potential associated factors using univariable and multivariable analysis.

Results: Of the 32,970,850 individuals, we identified 30,250 individuals with PaC with an overall prevalence of 0.08%. Individuals with PaC were more likely to be males, seniors (age, >65 years), and White, compared with patients without PaC. In subgroup analysis of chronic pancreatitis, individuals on ASA, individuals >65 years, White, and White males were less likely to have PaC, and non-White females were more likely to have PaC.

Conclusions: This is the largest population-based study evaluating the epidemiology of PaC. We observed a protective association of ASA on a subgroup of patients with PaC and chronic pancreatitis.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Aspirin / adverse effects*
  • Databases, Factual / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / chemically induced*
  • Pancreatic Neoplasms / epidemiology*
  • Population Surveillance / methods*
  • Prevalence
  • United States / epidemiology
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin