In December 2019, The Norwegian Cancer Society gave money to develop and run a clinical registry for pancreatic cancer, with a three-year time frame. This is the second edition of the annual report for pancreatic cancer.
From 1990 until 2021, there has been a stable incidence of pancreatic cancer in Norway for both sexes. 967 patients were diagnosed with pancreatic cancer in 2021. Of these, 76 were identified with neuroendocrine neoplasms and are not included in the register. The annual report includes patients with pancreatic adenocarcinoma.
Diagnosis of pancreatic cancer is done locally, and pancreatic cancer surgery is centralized at Oslo University Hospital, Stavanger University Hospital, Haukeland University Hospital, St.Olav Hospital and UNN Tromsø. A total of 16.2 % of patients operated on and the figures for many of the healthcare institutions are too small for the variations to be given much weight. The report shows that 17.3 % of all patients operated on for pancreatic cancer in 2020 and 2021 received neoadjuvant chemotherapy.
The risk of developing pancreatic cancer increases with age. Pancreatic cancer has few and diffuse symptoms, which often lead to the disease being discovered late. The majority of patients with pancreatic cancer cannot be operated on, either because of distant metastases, locally advanced disease or because of old age and comorbidities that are not compatible with operative treatment. Of the 1,107 patients who were diagnosed in the period 2020-June 2021, but were not operated on, 41.5 % palliative chemotherapy. The proportion who received palliative chemotherapy varies somewhat between the admission areas. Of all patients diagnosed with pancreatic cancer, 49.1 % did not receive any tumor-directed treatment, which underlines that the burden of the disease, for many, is already high at the time of diagnosis.
New in this year's report is a table showing more detailed data on surgery. This data is obtained from NoRGast (Norwegian register for gastrosurgery) and is the result of a collaboration between NoRGast and the Norwegian Cancer Registry.
Furthermore, an analysis has been carried out which shows that the proportion of patients who received chemotherapy less than 4 weeks before death is 12.7 % nationally. This is a number you want to keep low.
The report shows that 1-year overall survival among all pancreatic cancer patients is 36.3 % and 3-year overall survival for the same group is 12.2%. Those operated on have a 1-year overall survival of 78.5 % and a 3-year overall survival of 43.3 %. New from this year's report is the figure showing an estimated 5-year overall survival among those operated on of 25.5 %.
In 2021, a new diagnostic report for pancreatic cancer was put into production. This is a concise and informative report, and an important measure to gain more knowledge about which examination patients undergo, as well as helping to ensure a high degree of coverage in the cancer register. The information from this must be linked with pathology information and treatment information from specialist systems.
Unfortunately, the coverage rate is too low (51.2 %) for data to be presented in this year's report. The clinical registry has implemented measures to increase reporting, but in the coming year will continue to work on this and develop more measures to ensure better reporting for the year 2022.