Background <p>Pancreatic cancer incidence is increasing worldwide while survival remains poor. The incidence varies significantly across different regions. The aim of the present study was to analyse incidence, mortality and survival of patients diagnosed with pancreatic cancer in the canton of Zurich, Switzerland.</p> Methods <p>Population-based cancer registry data and cause of death statistics of the canton of Zurich from 1981 to 2021 were analysed. Age-standardised incidence and mortality rates per 100’000 person-years and net survival were calculated. Joinpoint regression analysis was conducted to identify significant changes in time trends while net survival was estimated using the Pohar-Perme method.</p> Results <p>Age-standardised incidence rate of pancreatic adenocarcinomas (PAC) remained stable between 1981 and 2000 and then increased from 2000 to 2021, while pancreatic neuroendocrine tumours (PNET) incidence increased throughout and pancreatic cancers non histologically or cytologically confirmed (PC Non-HC) decreased. Overall age-standardised mortality rate remained stable. Five-year net survival was moderate for PNET (54.8%), but poor for PAC (4.8%) and PC Non-HC (1.2%). Among patients with PAC, survival declined with increasing age, earlier diagnosis year and advanced stage.</p> Conclusions <p>Over the past 40 years, PNET incidence slowly increased. In contrast, PAC incidence significantly increased within the last 20 years. The underlying causes of the observed increase in PAC incidence might be attributable to special risk factors, e.g. obesity, but other risk factors should also be considered. Mortality rates of pancreatic cancer were stable and net survival was poor.</p>