3. Epidemiology – Pancreatic Cancer

More than 95% of pancreatic carcinomas are adenocarcinomas and arise from malignant degeneration of the exocrine portion of the pancreas. According to current knowledge, exocrine pancreatic cancer arises from premalignant precursors of the epithelium in the pancreatic duct (Pancreatic Intraepithelial Neoplasias, PanINs). In addition, there are cystic tumors, which also arise from the duct cells, or acinar tumors, which arise from the secretory parenchymal cells of the pancreas. Less common are endocrine tumors, which derive from the endocrine cells of the islets of Langerhans.

In Germany, approximately 20,230 people [2] are diagnosed with pancreatic ductal carcinoma each year (www.gekid.de). Men and women are affected with approximately equal frequency. Pancreatic cancer ranks 6th in both men and women in the statistics for new cases of cancer in Germany [2]. Most of those affected develop the disease at an older age: the mean age of onset is 72 for men and 76 for women [2]. Due to the poor prognosis, almost as many people die from pancreatic cancer as develop the disease: with approximately 19,000 deaths in 2021, pancreatic cancer is the fourth most common cause of cancer death: 7.5% of all cancer deaths in men and 9.0% of cancer deaths in women [2]. Thus, the incidence of pancreatic cancer is very close to the annual mortality rate and long-term survival is the exception. Accordingly, the relative 5-year survival rate for pancreatic cancer is 11% in both men and women, the lowest survival rate among all cancers in Germany besides mesothelioma [2]. The reasons for this include late diagnosis, the resulting low curative resection rate, as well as early and aggressive metastasis.