Association Between Pancreatitis and Subsequent Risk of Pancreatic Cancer: a Systematic Review of Epidemiological Studies

Abstract

This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February 5 th , 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). Howeever, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.

Chronic Pancreatitis and Pancreatic Cancer Risk: A Systematic Review and Meta-analysis

“…However, previous research is limited by potential misclassification and possible confounding by tobacco smoking and alcohol consumption. Previously, this association was examined in two metaanalyses, both reporting a substantially increased risk 6,7 . However, these meta-analyses included only a subset of the published work available at the time, and they lacked information on the temporality of the association between chronic pancreatitis and pancreatic cancer.…”

Alipogene Tiparvovec: A Review of Its Use in Adults with Familial Lipoprotein Lipase Deficiency

“…However, the most debilitating clinical manifestation of the disease is recurrent, severe and potentially life-threatening acute pancreatitis, with severe hypertriglyceridaemia being one of the primary risk factors for pancreatitis and the third leading cause of acute pancreatitis [2][3][4]. Pancreatitis is associated with an increased risk of pancreatic cancer [5] and results in significant morbidity and mortality in 20-30 % of patients, impacting on health-related qualityof-life and placing a significant economic burden on healthcare systems [3,4].…”

Health Effects of Metals in Particulate Matter

“…The pathophysiology and etiology of pancreatic damage are still unknown, and usually are lethal [170] [171] [172]. Vanadium induces an increase in pancreatic enzymes, hypertrophic acinar cells, which results in an acute pancreatitis [173].…”