{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:07:41Z","timestamp":1771308461236,"version":"3.50.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatic cancer (PC) is among the most lethal cancers, with increasing incidence and poor survival worldwide. We examined population-based PC incidence and survival trends in the Spanish region of Murcia during 1983-2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Population-based registry data were obtained. All primary invasive PC cases from 1983\u20132018 were included and classified as pancreatic neuroendocrine neoplasm (pNENs), non-pNENs and non-histologically-confirmed tumors. Age-specific and age-standardized incidence rates per 100,000 person-years (py) were calculated. Annual percentage changes (APCs) were estimated via joinpoint regression. Age-standardized net survival was calculated using the Pohar-Perme method. All results were stratified by sex, age, histological group and period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 3819 patients were diagnosed. The incidence rates in men increased from 11.2\/100,000 py (1983\u20131988) to 21.8\/100,000 py (2013\u20132018), and those in women increased from 7.2 to 15.2\/100,000 py. The APC was more pronounced in women aged 15\u201344 years (APC\u00a0=+\u00a05.2%, 95% CI\u00a0=\u00a01.5, 9.0) than in men (APC\u00a0=+\u00a00.5, 95% CI=-1.5, 2.5). Among all confirmed cases, 93.3% were non-pNENs (APC\u00a0=\u00a05.4%, 95% CI\u00a0=\u00a04.9, 6.2), and 6.7% were pNENs (APC\u00a0=\u00a08.3%, 95% CI\u00a0=\u00a06.3, 13.6). Five-year survival rates were 5.1% (95% CI\u00a0=\u00a03.3, 7.0) in the 1990s and 11.4% (95% CI\u00a0=\u00a02.7, 13.1) in the 2010s (non-pNEN patients=7.4%, pNEN patients=57.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PC incidence increased in the Spanish region of Murcia, particularly among younger women and pNEN patients. Survival improved, doubling from the 1990s to the 2010s. These findings highlight the need to develop preventive strategies targeting high-risk populations, especially young women, while improving early PC diagnosis to continue increasing PC survival rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1717142","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:35Z","timestamp":1771305515000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shifting epidemiology of pancreatic cancer in Southeast Spain (1983-2018): emerging patterns in younger women and neuroendocrine neoplasms"],"prefix":"10.3389","volume":"16","author":[{"given":"Sandra M.","family":"Colorado-Yohar","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council","place":["Murcia, Spain"]},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)","place":["Madrid, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]},{"name":"Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia","place":["Medell\u00edn, Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica","family":"Ballesta-Ruiz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council","place":["Murcia, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]},{"name":"Health and Social Sciences Department, University of Murcia","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo J.","family":"Vaamonde-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council","place":["Murcia, Spain"]},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)","place":["Madrid, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Salmer\u00f3n","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)","place":["Madrid, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]},{"name":"Health and Social Sciences Department, University of Murcia","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Corral","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]},{"name":"Department of Medicine, Faculty of Medicine, University of Murcia","place":["Murcia, Spain"]},{"name":"Servicio de Hematolog\u00eda y Oncolog\u00eda M\u00e9dica, Centro Regional de Hemodonaci\u00f3n, Hospital Universitario Morales Meseguer","place":["Murcia, Spain"]},{"name":"CIBER Enfermedades Raras","place":["Madrid, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Marcos-Gragera","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)","place":["Madrid, Spain"]},{"name":"Descriptive Epidemiology, Genetics and Cancer Prevention Research Group, Girona, Biomedical Research Institute (IdiBGi-CERCA)","place":["Girona, Spain"]},{"name":"Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health Government of Catalonia, Catalan Institute of Oncology","place":["Girona, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"S\u00e1nchez-Gil","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council","place":["Murcia, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Dolores","family":"Chirlaque","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Murcia Regional Health Council","place":["Murcia, Spain"]},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)","place":["Madrid, Spain"]},{"name":"Biomedical Research Institute of Murcia (IMIB)","place":["Murcia, Spain"]},{"name":"Health and Social Sciences Department, University of Murcia","place":["Murcia, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i27.4298","article-title":"Pancreatic cancer: A review of epidemiology, trend, and risk factors","volume":"27","author":"Hu","year":"2021","journal-title":"World J Gastroenterol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.10.007","article-title":"Worldwide Burden of, Risk Factors for, and Trends in Pancreatic Cancer","volume":"160","author":"Huang","year":"2021","journal-title":"Gastroenterology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1053\/j.gastro.2023.01.022","article-title":"Increasing pancreatic cancer incidence in young women in the United States: A population-based time-trend analysis, 2001-2018","volume":"164","author":"Abboud","year":"2023","journal-title":"Gastroenterology"},{"key":"B5","unstructured":"Estimaciones de la Incidencia de C\u00e1ncer en Espa\u00f1a, 2024\n          \n          \n          \n          2024"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14102441","article-title":"Cancer survival in adults in Spain: A population-based study of the spanish network of cancer registries (REDECAN)","volume":"14","author":"Guevara","year":"2022","journal-title":"Cancers"},{"key":"B7","unstructured":"Diet, nutrition, physical activity and pancreatic cancer\n          \n          \n          \n          2018"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31367","article-title":"Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study","volume":"143","author":"Naudin","year":"2018","journal-title":"Int J Cancer"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-1027","article-title":"Pancreatic cancer risk in relation to lifetime smoking patterns, tobacco type, and dose-response relationships","volume":"29","author":"Molina-Montes","year":"2020","journal-title":"Cancer epidemiology Biomarkers prevention: Publ Am Assoc Cancer Research cosponsored by Am Soc Prev Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyab115","article-title":"Plasma concentrations of persistent organic pollutants and pancreatic cancer risk","volume":"51","author":"Porta","year":"2022","journal-title":"Int J Epidemiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.005","article-title":"Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018","volume":"103","author":"Ferlay","year":"2018","journal-title":"Eur J Cancer (Oxford England: 1990)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1186\/s12916-024-03574-x","article-title":"Cancer incidence (2000-2020) among individuals under 35: an emerging sex disparity in oncology","volume":"22","author":"Cavazzani","year":"2024","journal-title":"BMC Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/cas.13971","article-title":"Development of novel diagnostic system for pancreatic cancer, including early stages, measuring mRNA of whole blood cells","volume":"110","author":"Sakai","year":"2019","journal-title":"Cancer Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1483306","article-title":"Emerging horizons on molecular and circulating biomarkers in pancreatic adenocarcinoma","volume":"14","author":"Moretti","year":"2024","journal-title":"Front Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10232","article-title":"Screening for pancreatic cancer: US preventive services task force reaffirmation recommendation statement","volume":"322","author":"Owens","year":"2019","journal-title":"JAMA"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2022.102204","article-title":"Incidence and relative survival of pancreatic adenocarcinoma and pancreatic neuroendocrine neoplasms in Germany, 2009-2018. An in-depth analysis of two population-based cancer registries","volume":"79","author":"Stang","year":"2022","journal-title":"Cancer Epidemiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1007\/s12094-016-1607-9","article-title":"Cancer incidence in Spain, 2015","volume":"19","author":"Galceran","year":"2017","journal-title":"Clin Trans oncology: Off Publ Fed Spanish Oncol Societies Natl Cancer Institute Mexico"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2022.102230","article-title":"Trends in pancreatic cancer incidence, characteristics, and outcomes in Denmark 1980-2019: A nationwide cohort study","volume":"80","author":"Kirkeg\u00e5rd","year":"2022","journal-title":"Cancer Epidemiol"},{"key":"B19","unstructured":"Padr\u00f3n Municipal de Habitantes"},{"key":"B20","volume-title":"Cancer Incidence in Five Continents, Vol. XI (electronic version). (IARC Scientific Publication No. 166)","author":"Bray","year":"2019"},{"key":"B21","volume-title":"International rules for multiple primary cancers","year":"2004"},{"key":"B22","volume-title":"Check Conversion Programs for Cancer Registries. (IARC\/IACR Tools for Cancer Registries)","author":"Ferlay","year":"2005"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.11.003","article-title":"The EUROCARE-4 database on cancer survival in Europe: data standardisation, quality control and methods of statistical analysis","volume":"45","author":"De Angelis","year":"2009","journal-title":"Eur J Cancer (Oxford England: 1990)"},{"key":"B24","unstructured":"Regulation General Data Protection. Regulation (EU) 2016\/679 of the European Parliament and of the Council of 27 April 2016"},{"key":"B25","volume-title":"Guidelines on confidentiality in population- based Cancer Registration in the European Union","year":"2002"},{"key":"B26","first-page":"1","volume-title":"Statistical methods in cancer research. Volume II\u2013The design and analysis of cohort studies","author":"Breslow","year":"1987"},{"key":"B27","volume-title":"Revision of the European Standard Population\u2014Report of Eurostat\u2019s Task Force","year":"2013"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/kxn021","article-title":"An approach to estimation in relative survival regression","volume":"10","author":"Perme","year":"2009","journal-title":"Biostatistics (Oxford England)"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2004.07.002","article-title":"Standard cancer patient population for age standardising survival ratios","volume":"40","author":"Corazziari","year":"2004","journal-title":"Eur J Cancer (Oxford England: 1990)"},{"key":"B30","unstructured":"Joinpoint Regression Program, Version 4.6.0.0 - April 2018; Statistical Methodology and Applications Branch, Surveillance Research Program NCI. No Title\n          \n          \n          2018"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.18859","article-title":"Incidence of pancreatic cancer by age and sex in the US, 2000-2018","volume":"326","author":"Gaddam","year":"2021","journal-title":"JAMA"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030870","article-title":"Pancreatic cancer incidence trends by race, ethnicity, age and sex in the United States: A population-based study, 2000-2018","volume":"15","author":"Samaan","year":"2023","journal-title":"Cancers"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17249538","article-title":"Incidence and survival trends of pancreatic cancer in girona: impact of the change in patient care in the last 25 years","volume":"17","author":"Garc\u00eda-Velasco","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14082","article-title":"Is there a recent epidemic of women\u2019s drinking? A critical review of national studies","volume":"43","author":"Keyes","year":"2019","journal-title":"Alcoholism Clin Exp Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35135","article-title":"Clinical and molecular features of early onset pancreatic adenocarcinoma","volume":"155","author":"R\u00e9mond","year":"2024","journal-title":"Int J Cancer"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16050971","article-title":"The disproportionate rise in pancreatic cancer in younger women is due to a rise in adenocarcinoma and not neuroendocrine tumors: A nationwide time-trend analysis using 2001\u20132018 United States cancer statistics databases","volume":"16","author":"Jiang","year":"2024","journal-title":"Cancers"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000303","article-title":"Trends in net survival from pancreatic cancer in six European Latin countries: results from the SUDCAN population-based study","volume":"26","author":"Bouvier","year":"2017","journal-title":"Eur J Cancer prevention: Off J Eur Cancer Prev Organisation (ECP)"},{"key":"B38","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1186\/s12885-018-4610-4","article-title":"Trends in pancreatic adenocarcinoma incidence and mortality in the United States in the last four decades; a SEER-based study","volume":"18","author":"Saad","year":"2018","journal-title":"BMC Cancer"},{"key":"B39","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12916-018-1120-9","article-title":"Stratified survival of resected and overall pancreatic cancer patients in Europe and the USA in the early twenty-first century: a large, international population-based study","volume":"16","author":"Huang","year":"2018","journal-title":"BMC Med"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/goaf030","article-title":"Trends in pancreatic cancer incidence, prevalence, and survival outcomes by histological subtypes: a retrospective cohort study","volume":"13","author":"Lei","year":"2025","journal-title":"Gastroenterol Rep"},{"key":"B41","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ejrad.2017.04.009","article-title":"Imaging modalities in the diagnosis of pancreatic adenocarcinoma: A systematic review and meta-analysis of sensitivity, specificity and diagnostic accuracy","volume":"92","author":"Toft","year":"2017","journal-title":"Eur J Radiol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11101189","article-title":"Radiology","volume":"259","author":"Koelblinger","year":"2011","journal-title":"Radiology"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1097\/JP9.0000000000000216","article-title":"Global characteristics of pancreatic cancer survival: a comprehensive overview of survival analysis from cancer registration data","volume":"8","author":"Chen","year":"","journal-title":"J Pancreatology"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35267","article-title":"Survival scenarios of patients with localized and metastatic pancreatic adenocarcinoma: A population-based study","volume":"156","author":"Kuijper","year":"2025","journal-title":"Int J Cancer"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa004","article-title":"Recent trends in the incidence and survival of stage 1A pancreatic cancer: A surveillance, epidemiology, and end results analysis","volume":"112","author":"Blackford","year":"2020","journal-title":"J Natl Cancer Institute"},{"key":"B46","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA: Cancer J Clin"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i43.4846","article-title":"Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes","volume":"24","author":"McGuigan","year":"2018","journal-title":"World J Gastroenterol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2023.02.014","article-title":"Pancreatic cancer: Advances and challenges","volume":"186","author":"Halbrook","year":"2023","journal-title":"Cell"},{"key":"B49","doi-asserted-by":"publisher","first-page":"e073995","DOI":"10.1136\/bmj-2022-073995","article-title":"Advances in the management of pancreatic cancer","volume":"383","author":"Del Chiaro","year":"2023","journal-title":"BMJ (Clinical Res ed)"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34771","article-title":"Elucidating the role of blood metabolites on pancreatic cancer risk using two-sample Mendelian randomization analysis","volume":"154","author":"Zhong","year":"2024","journal-title":"Int J Cancer"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34466","article-title":"Associations between genetically predicted levels of blood metabolites and pancreatic cancer risk","volume":"153","author":"Zhong","year":"2023","journal-title":"Int J Cancer"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2022.102196","article-title":"World-wide trends in net survival from pancreatic cancer by morphological sub-type: An analysis of 1,258,329 adults diagnosed in 58 countries during 2000-2014 (CONCORD-3)","volume":"80","author":"Nik\u0161i\u0107","year":"2022","journal-title":"Cancer Epidemiol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17030377","article-title":"Surgical management of gastroenteropancreatic neuroendocrine tumors","volume":"17","author":"Kenney","year":"2025","journal-title":"Cancers"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.5578\/turkjsurg.4367","article-title":"Are PNETs radiotherapy resistant","volume":"36","author":"Benderli Cihan","year":"2020","journal-title":"Turkish J Surg"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1717142\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:18:38Z","timestamp":1771305518000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1717142\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":54,"alternative-id":["10.3389\/fonc.2026.1717142"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1717142","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"article-number":"1717142"}}