Pancreatic cancer quality of care index trends, socioeconomic disparities, and future projections (1990-2035): A global epidemiological study.

[PURPOSE] Pancreatic cancer remains a significant global health challenge with a poor prognosis. Assessing the quality of care is crucial for improving outcomes and reducing disparities. This study aims to evaluate the global, regional, and national quality of care for pancreatic cancer from 1990 to 2021 and project future trends to 2035.

[METHODS] We utilized data from the Global Burden of Disease (2021). Quality of care index (QCI) was constructed using principal component analysis on four key ratios: mortality-to-incidence, DALYs-to-prevalence, prevalence-to-incidence, and YLLs-to-YLDs. We analyzed trends by socio-demographic Index (SDI) and assessed inequalities using the slope index of inequality (SII) and concentration index (CI). An exponential smoothing model was used to project QCI scores to 2035.

[RESULTS] Globally, the QCI for pancreatic cancer increased from 25.4 in 1990 to 45.4 in 2021. However, significant disparities exist. In 2021, high-SDI countries had the highest QCI (75.8), while low-SDI countries had the lowest (4.8). Socio-economic inequality in QCI widened from 1990 to 2021, with the SII increasing from 9.78 to 21.56 and the CI increasing from 0.19 to 0.25. While the global QCI was slightly higher for females (47.5 vs 43.7), gender disparity analysis revealed a widespread male advantage at the national level, with females receiving a lower quality of care in 92.65% (189/204) of countries. Projections suggest that the global QCI will decline to 66.5 by 2035.

[CONCLUSION] The quality of care for pancreatic cancer has improved modestly worldwide but is marked by significant socioeconomic disparities.