High Incidence of Extrapancreatic Carcinoma in Chronic Pancreatitis

Abstract

In the prospective clinical long-term study of 246 patients with chronic pancreatitis, 26 patients (24 men) developed 27 histologically proved malignant tumors (11%). Four additional patients with neoplasia were excluded (papilloma, two; Bowen's disease of the tonsils, one; and seminoma, one, occurring 8 years before onset of pancreatitis). In six patients pancreatic cancer was diagnosed (2.4%), which indicates a slightly increased risk over the general population. Interestingly, 21 patients developed extrapancreatic cancer (8.5%), including a very high incidence that has not been noted previously. The cancers were located in the oral cavity (in six), larynx (three), bronchus (eight), and gastrointestinal tract (four). The data suggest a causal relationship between chronic pancreatitis and cancer. As possible factors, smoking, alcohol abuse, diabetes, malnutrition, immune deficiency, and high dietary fat intake are discussed. There is, however, no definite evidence for any single known factor.

Clinical Features of Chronic Pancreatitis in Korea: A Multicenter Nationwide Study

“…Moreover, the cumulative risk of pancreatic cancer increased distinctly, and 10 and 20 years after a diagnosis of CP, the risks were found to be 1.8 and 4%, respectively, in a multicenter study conducted by Lowenfels et al[ 24]. The incidence of associated pancreatic cancer was found to be 1.6% in a recent Japanese study[ 28], and the overall incidence of pancreatic cancer in our study was 3.1%, which is similar to several Western studies that reported a higher incidence of pancreatic cancer in CP [20, 26, 27]. Smoking is the most well-established risk factor of pancreatic cancer, and this risk appears to be independent of sex, country, or type of pancreatitis[ 25].…”

“…The incidence of pancreatic cancer during the course of CP has been reported to range from 1.1 to 3% in the West[ 20,22,23,24,25,26,27]. Moreover, the cumulative risk of pancreatic cancer increased distinctly, and 10 and 20 years after a diagnosis of CP, the risks were found to be 1.8 and 4%, respectively, in a multicenter study conducted by Lowenfels et al[ 24].…”

Demographic characteristics of chronic pancreatitis patients in the era of endosonography: Experience of a single tertiary referral center in Turkey

“…The cumulative risks were reported to be 1.8% and 4%, respectively, 10 and 20 years after diagnosis (36). In our study the overall incidence of pancreatic cancer was 2.3%, which is similar to that in several Western studies (37,41,42).…”

Natural Course of Chronic Pancreatitis

“…In clinical studies, varying figures concerning the incidence of pancreatic carcinoma in patients with chronic pancreatitis have been reported reaching from 1.4 to 2.7% [3,7,16,96,97]. A multicenter historical cohort study of 2,015 subjects with chronic pancreatitis involved clinical centers in six countries [98].…”