The Burden of Pancreatic Cancer in ASEAN Member States (1990-2023) and Future Trends Forecasting: A GBD 2023 Analysis.

OBJECTIVE: To characterize temporal trends, demographic drivers, and socioeconomic inequalities in pancreatic cancer burden across the 11 Association of Southeast Asian Nations (ASEAN) member states and to project burden through 2050. PATIENTS AND METHODS: We analyzed Global Burden of Disease 2023 estimates for 11 ASEAN member states from January 1, 1990, through December 31, 2023. Trends were assessed using age-standardized rates, estimated annual percentage changes, and joinpoint regression; drivers and inequalities were assessed using decomposition and inequality analyses, respectively; and burden from 2024 through 2050 was projected using autoregressive integrated moving average models. Data were downloaded from the Global Health Data Exchange on October 31, 2025. RESULTS: In 2023, ASEAN had 26,568 incident cases, 25,717 deaths, and 720,507 disability-adjusted life years (DALYs), increases of 360%, 355%, and 343%, respectively, from 1990. Regional age-standardized incidence, mortality, and DALY rates were 3.82, 3.70, and 103.70 per 100,000, respectively. Burden patterns varied across countries: Indonesia and Thailand had the largest absolute burdens, Singapore had the highest age-standardized rates, and Vietnam showed the fastest increases. The contributions of population aging and changes in age-specific rates also differed among countries. Model-based projections suggested that the regional age-standardized mortality rate may reach 7.02 per 100,000 by 2050. CONCLUSION: Pancreatic cancer burden in ASEAN increased substantially and is projected to continue increasing, requiring country-specific prevention and health-system strategies.