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The Global, Regional, and National Burden of Pancreatic Cancer and Its Attributable Risk Factors in 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017 Publisher Pubmed



Pourshams A1 ; Sepanlou SG1, 14 ; Ikuta KS15, 16 ; Bisignano C15 ; Safiri S19, 20 ; Roshandel G1, 24 ; Sharif M25, 26 ; Khatibian M1 ; Fitzmaurice C15, 17 ; Nixon MR15 ; Abbasi N27 ; Afarideh M6 ; Ahmadian E21, 29 ; Akinyemiju T30, 31 Show All Authors
Authors
  1. Pourshams A1
  2. Sepanlou SG1, 14
  3. Ikuta KS15, 16
  4. Bisignano C15
  5. Safiri S19, 20
  6. Roshandel G1, 24
  7. Sharif M25, 26
  8. Khatibian M1
  9. Fitzmaurice C15, 17
  10. Nixon MR15
  11. Abbasi N27
  12. Afarideh M6
  13. Ahmadian E21, 29
  14. Akinyemiju T30, 31
  15. Alahdab F32
  16. Alam T15
  17. Alipour V34, 35
  18. Allen CA15
  19. Anber NH37
  20. Ansarimoghaddam A38
  21. Arabloo J35
  22. Badawi A39, 40
  23. Bagherzadeh M42
  24. Belayneh YM43
  25. Biadgo B44
  26. Bijani A45
  27. Biondi A47
  28. Bjorge T49, 50
  29. Borzi AM46
  30. Bosetti C52
  31. Briko AN53
  32. Briko NI54
  33. Carreras G55
  34. Carvalho F56, 57
  35. Choi JYJ59
  36. Chu DT60
  37. Dang AK61
  38. Daryani A62
  39. Davitoiu DV63, 66
  40. Demoz GT67, 69
  41. Desai R70
  42. Dey S71
  43. Do HT73
  44. Do HP72
  45. Eftekhari A21, 75
  46. Esteghamati A6
  47. Farzadfar F11
  48. Fernandes E58
  49. Filip I76, 78
  50. Fischer F79
  51. Foroutan M80
  52. Gad MM81, 82
  53. Gallus S51
  54. Geta B43
  55. Gorini G83
  56. Hafezinejad N13, 84
  57. Harvey JD15
  58. Hasankhani M23
  59. Hasanzadeh A5, 74
  60. Hassanipour S85
  61. Hay SI15, 18
  62. Hidru HD87
  63. Hoang CL72
  64. Hostiuc S65, 88
  65. Househ M89, 90
  66. Ilesanmi OS91
  67. Ilic MD92
  68. Irvani SSN93
  69. Balalami NJ94
  70. James SL15
  71. Joukar F85
  72. Kasaeian A7, 8
  73. Kassa TD95
  74. Kengne AP98, 99
  75. Khalilov R28
  76. Khan EA100
  77. Khater A101
  78. Shadmani FK102
  79. Kocarnik JM15, 103
  80. Komaki H104, 105
  81. Koyanagi A106, 107
  82. Kumar V108
  83. La Vecchia C109
  84. Lopukhov PD54
  85. Manafi F41
  86. Manafi N36, 111
  87. Manda AL112
  88. Mansourghanaei F85
  89. Mehta D113
  90. Mehta V114
  91. Meier T115, 116
  92. Meles HG97
  93. Mengistu G43, 117
  94. Miazgowski T118
  95. Mohamadnejad M1, 10
  96. Mohammadianhafshejani A119
  97. Mohammadookhorasani M120
  98. Mohammed S121, 122
  99. Mohebi F9, 11
  100. Mokdad AH15, 18
  101. Monasta L123
  102. Moossavi M124
  103. Moradzadeh R125
  104. Naik G126
  105. Negoi I63, 64
  106. Nguyen CT61
  107. Nguyen LH72
  108. Nguyen TH72
  109. Olagunju AT128, 129
  110. Olagunju TO127
  111. Pennini A15
  112. Rabiee M130
  113. Rabiee N42
  114. Radfar A77, 131
  115. Rahimi M22
  116. Rath GK132
  117. Rawaf DL134, 135
  118. Rawaf S133, 136
  119. Rezaei N12, 137
  120. Rezapour A35
  121. Saad AM139
  122. Saadatagah S4
  123. Sahebkar A140, 141
  124. Salimzadeh H1
  125. Samy AM138
  126. Sanabria J142, 143
  127. Sarveazad A33
  128. Sawhney M144
  129. Sekerija M145, 146
  130. Shabalkin P147
  131. Shaikh MA148
  132. Sharma R149
  133. Sheikhbahaei S6, 84
  134. Shirkoohi R2, 3
  135. Siddappa Malleshappa SK150
  136. Sisay M117
  137. Soreide K48, 151
  138. Soshnikov S152
  139. Sotoudehmanesh R1
  140. Starodubov VI154
  141. Subart ML15
  142. Tabaresseisdedos R155, 156
  143. Tadesse DBB110
  144. Traini E123
  145. Tran BX157
  146. Tran KB158, 159
  147. Ullah I160, 161
  148. Vacante M47
  149. Vahedianazimi A162
  150. Varavikova E153
  151. Westerman R163
  152. Wondafrash DZ68, 96
  153. Xu R15
  154. Yonemoto N164
  155. Zadnik V165
  156. Zhang ZJ166
  157. Malekzadeh R1, 14
  158. Naghavi M15, 18
Show Affiliations
Authors Affiliations
  1. 1. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Microbiology, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Iran National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Liver and Pancreatobiliary Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  11. 11. Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
  13. 13. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  14. 14. Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  15. 15. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  16. 16. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States
  17. 17. Division of Hematology, University of Washington, Seattle, WA, United States
  18. 18. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  19. 19. Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  20. 20. Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  21. 21. Department of Pharmacology and Toxicology, Tabriz University of Medical Sciences, Tabriz, Iran
  22. 22. Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  23. 23. School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
  24. 24. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  25. 25. Department of Basic Sciences, Islamic Azad University, Sari, Iran
  26. 26. Department of Laboratory Sciences, Islamic Azad University, Sari, Iran
  27. 27. Montreal Neurological Institute, McGill University, Montreal, QC, Canada
  28. 28. Department of Physiology, Baku State University, Baku, Azerbaijan
  29. 29. Institute of Radiation Problems of Azerbaijan, Baku State University, Baku, Azerbaijan
  30. 30. Department of Population Health Sciences, Duke University, Durham, NC, United States
  31. 31. Duke Global Health Institute, Duke University, Durham, NC, United States
  32. 32. Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  33. 33. Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
  34. 34. Health Economics Department, Iran University of Medical Sciences, Tehran, Iran
  35. 35. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  36. 36. Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran
  37. 37. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  38. 38. Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan, Iran
  39. 39. Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
  40. 40. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
  41. 41. Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
  42. 42. Department of Chemistry, Sharif University of Technology, Tehran, Iran
  43. 43. Department of Pharmacy, Wollo University, Dessie, Ethiopia
  44. 44. Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
  45. 45. Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
  46. 46. Department of Clinical and Molecular Biomedicine (MEDBIO), University of Catania, Catania, Italy
  47. 47. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  48. 48. Department of Clinical Medicine, University of Bergen, Bergen, Norway
  49. 49. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  50. 50. Cancer Registry of Norway, Oslo, Norway
  51. 51. Department of Environmental Health Science, Mario Negri Institute for Pharmacological Research, Milan, Italy
  52. 52. Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy
  53. 53. Department of Biomedical Technologies, Bauman Moscow State Technical University, Moscow, Russian Federation
  54. 54. Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  55. 55. Institute for Cancer Research, Prevention and Clinical Network, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
  56. 56. Applied Molecular Biosciences Unit, University of Porto, Porto, Portugal
  57. 57. Institute of Public Health, University of Porto, Porto, Portugal
  58. 58. REQUIMTE/LAQV, University of Porto, Porto, Portugal
  59. 59. Department of Biochemistry, Biomedical Science, Seoul National University Hospital, Seoul, South Korea
  60. 60. Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam
  61. 61. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  62. 62. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  63. 63. Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  64. 64. Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  65. 65. Faculty of Dentistry, Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  66. 66. Department of Surgery, Clinical Emergency Hospital Sf. Pantelimon, Bucharest, Romania
  67. 67. School of Pharmacy, Aksum University, Aksum, Ethiopia
  68. 68. Department of Pharmacology, Addis Ababa University, Addis Ababa, Ethiopia
  69. 69. Addis Ababa University, Addis Ababa, Ethiopia
  70. 70. Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
  71. 71. Disha Foundation, Gurgaon, India
  72. 72. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  73. 73. Center of Excellence in Public Health Nutrition, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  74. 74. Department of Microbiology, Maragheh University of Medical Sciences, Maragheh, Iran
  75. 75. Pharmacology and Toxicology Department, Maragheh University of Medical Sciences, Maragheh, Iran
  76. 76. Psychiatry Department, Kaiser Permanente, Fontana, CA, United States
  77. 77. College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, United States
  78. 78. Department of Health Sciences, A.T. Still University, Mesa, AZ, United States
  79. 79. Department of Public Health Medicine, Bielefeld University, Bielefeld, Germany
  80. 80. Abadan School of Medical Sciences, Abadan, Iran
  81. 81. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
  82. 82. Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
  83. 83. Occupational and Environmental Epidemiology Section, Cancer Prevention and Research Institute, Florence, Italy
  84. 84. Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, United States
  85. 85. Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
  86. 86. Guilan University of Medical Sciences, Rasht, Iran
  87. 87. Department of Epidemiology, Adigrat University, Adigrat, Ethiopia
  88. 88. Clinical Legal Medicine, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
  89. 89. Division of Information and Computing Technology, Hamad Bin Khalifa University, Doha, Qatar
  90. 90. Qatar Foundation for Education, Science, and Community Development, Doha, Qatar
  91. 91. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  92. 92. Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
  93. 93. Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  94. 94. Department of Psychosis, Babol Nushirvani University of Technology, Babol, Iran
  95. 95. Clinical Pharmacy Unit, Mekelle University, Mekelle, Ethiopia
  96. 96. Department of Pharmacology and Toxicology, Mekelle University, Mekelle, Ethiopia
  97. 97. Mekelle University, Mekelle, Ethiopia
  98. 98. Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
  99. 99. Department of Medicine, University of Cape Town, Cape Town, South Africa
  100. 100. Epidemiology and Biostatistics Department, Health Services Academy, Islamabad, Pakistan
  101. 101. Internal Medicine and Gastroenterology Department, National Hepatology and Tropical Research Institute, Cairo, Egypt
  102. 102. Department of Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
  103. 103. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
  104. 104. Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  105. 105. Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
  106. 106. CIBERSAM, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
  107. 107. Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
  108. 108. Department of Medicine, Brigham and Women’s Hospital, Harvard University, Boston, MA, United States
  109. 109. Clinical Medicine and Community Health Department, A.C.S. Medical College and Hospital, Milano, Italy
  110. 110. Department of Nursing, A.C.S. Medical College and Hospital, Milano, Italy
  111. 111. Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
  112. 112. Surgery Department, Emergency University Hospital Bucharest, Bucharest, Romania
  113. 113. Division of Gastroenterology and Hepatobiliary Disease, New York Medical College, Valhalla, NY, United States
  114. 114. Department of Internal Medicine, SevenHills Hospital, Mumbai, India
  115. 115. Institute for Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
  116. 116. Innovation Office, Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle, Germany
  117. 117. School of Pharmacy, Haramaya University, Harar, Ethiopia
  118. 118. Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
  119. 119. Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
  120. 120. Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
  121. 121. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  122. 122. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  123. 123. Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
  124. 124. Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
  125. 125. Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
  126. 126. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
  127. 127. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
  128. 128. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
  129. 129. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  130. 130. Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
  131. 131. Medichem, Barcelona, Spain
  132. 132. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
  133. 133. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  134. 134. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  135. 135. University College London Hospitals, London, United Kingdom
  136. 136. Academic Public Health Department, Public Health England, London, United Kingdom
  137. 137. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  138. 138. Department of Entomology, Ain Shams University, Cairo, Egypt
  139. 139. Faculty of Medicine, Ain Shams University, Cairo, Egypt
  140. 140. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  141. 141. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  142. 142. Department of Surgery, Marshall University, Huntington, WV, United States
  143. 143. Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, United States
  144. 144. Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States
  145. 145. Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
  146. 146. Division of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
  147. 147. Cancer Research and Development Department, N.N. Blokhin National Medical Cancer Research Center, Moscow, Russian Federation
  148. 148. Independent consultant, Karachi, Pakistan
  149. 149. University School of Management and Entrepreneurship, Delhi Technological University, New Delhi, India
  150. 150. Department of Hematology-Oncology, Baystate Medical Center, Springfield, MA, United States
  151. 151. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
  152. 152. Research Development Department, Moscow, Russian Federation
  153. 153. Central Research Institute of Cytology and Genetics, Moscow, Russian Federation
  154. 154. Federal Research Institute for Health Organization and Informatics of the Ministry of Health (FRIHOI), Moscow, Russian Federation
  155. 155. Department of Medicine, University of Valencia, Valencia, Spain
  156. 156. Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
  157. 157. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  158. 158. Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
  159. 159. Department of Clinical Hematology and Toxicology, Military Medical University, Hanoi, Viet Nam
  160. 160. Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
  161. 161. TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
  162. 162. Baqiyatallah University of Medical Sciences, Tehran, Iran
  163. 163. Competence Center of Mortality-Follow-Up, German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
  164. 164. Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
  165. 165. Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
  166. 166. Department of Preventive Medicine, Wuhan University, Wuhan, China

Source: The Lancet Gastroenterology and Hepatology Published:2019


Abstract

Background: Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods: Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings: In 2017, there were 448 000 (95% UI 439 000–456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000–221 000; 51·9%) were in males. The age-standardised incidence rate was 5·0 (4·9–5·1) per 100 000 person-years in 1990 and increased to 5·7 (5·6–5·8) per 100 000 person-years in 2017. There was a 2·3 times increase in number of deaths for both sexes from 196 000 (193 000–200 000) in 1990 to 441 000 (433 000–449 000) in 2017. There was a 2·1 times increase in DALYs due to pancreatic cancer, increasing from 4·4 million (4·3–4·5) in 1990 to 9·1 million (8·9–9·3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17·4 [15·8–19·0] per 100 000 person-years) and Uruguay (12·1 [10·9–13·5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1·9 [1·5–2·3] per 100 000 person-years) had the lowest rate in 2017, and Sao Tome and Principe (1·3 [1·1–1·5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65–69 years for males and at 75–79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21·1% [18·8–23·7]), high fasting plasma glucose (8·9% [2·1–19·4]), and high body-mass index (6·2% [2·5–11·4]) in 2017. Interpretation: Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Funding: Bill & Melinda Gates Foundation. © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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