Incidence and risk of pancreatic cancer in patients with chronic pancreatitis: defining the optimal subgroup for surveillance

Abstract

We aimed to present the incidence and risk factors for pancreatic cancer in a multicenter retrospective cohort of patients with chronic pancreatitis (CP). Patients with ICD-10 codes for CP (K86.0, K86.1) who underwent abdominal CT or MRI between January 2010 and December 2021 in seven academic hospitals were analyzed. After exclusions, we identified 727 patients with definite CP with a median follow-up of 3.6 years (range 1.0‒12.9). During 3290 person-years of observation, pancreatic cancers were diagnosed in 16 patients (2.20%, 0.49% per year) after a median follow-up of 2.4 years (range 1.4‒6.6), with an age- and sex-standardized incidence ratio of 18.1 (95% CI 10.4‒29.5). The underlying CPs in the 16 pancreatic cancers were classified as chronic obstructive pancreatitis (10, 63%), chronic obstructive and calcifying pancreatitis (4, 25%), chronic calcifying pancreatitis (1, 6%), and autoimmune pancreatitis (1, 6%). Factors associated with pancreatic cancer development included age (HR 4.830, p = 0.006), parenchymal calcification (HR 0.213, p = 0.003), pancreatic duct stricture (HR 2.706, p = 0.048), and serum CA 19‒9 level (HR 3.567, p = 0.014). After adjustment, age over 60 years (HR 4.540, p = 0.009) and serum CA 19‒9 levels greater than 100 U/mL (HR 3.528, p = 0.015) were independent risk factors for pancreatic cancer.

Incidence and risk of pancreatic cancer in patients with acute or chronic pancreatitis: a population-based cohort study

“…11 A recent study conducted in South Korea also reported that CP patients with parenchymal calci cation have a low risk of PC. 22 Based on these ndings, including our own results, it is suggested that PC risks are determined by in ammation in the pancreas rather than chronicity.…”

“…18 A Veterans study in USA revealed the cumulative incidence of 1.04% in the CP group, which was higher than the 0.20% in the control group. 3 Recent studies conducted in South Korea reported the cumulative PC incidences of 2.20% in a hospital based study 22 and 0.68% in a population based study. 23 Another study on patients who underwent surgery for CP showed a higher cumulative incidence of PC with rates of 1.48% at 3 years, 2.63% at 6 years, and 3.71% at 9 years after surgery.…”

Machine Learning Predicts Patients With New-onset Diabetes at Risk of Pancreatic Cancer

“…CA 19-9 is the only approved biomarker for PDAC, but it is not authorized to screen for PDAC. CA 19-9 may have diagnostic value in patients with chronic pancreatitis to detect PDAC 43 . A biomarker would be helpful to stratify those patients who are neither low risk nor high risk for developing PDAC.…”

Gambaran Makroskopik dan Mikroskopik Pankreatitis Kronis dalam Pemeriksaan Postmortem

“…Meskipun komplikasi di bagian saluran pencernaan tidak umm terjadi, tetapi kondisi ini berkontribusi dalam peningkatan morbiditas dan mortalitas yang signifikan. [5][6][7] Pada tahun 2020, perkiraan kejadian pankreatitis kronis adalah sebesar 4,4 sampai 14 per 100.000 orang, dengan prevalensi 36,9 -52,4 per 100.000 orang dan didominasi oleh laki-laki. 8 Penelitian yang dilakukan Miyake et al, pada 84 pasien pankreatitis kronis alkoholik dan 51 pasien pankreatitis kronis non alkoholik dan diperoleh hasil bahwa angka kematian akibat pankreatitis kronik alkoholik dan non alkoholik adalah 23%.…”

“…Insidensi terjadinya kanker pankreas secara global sebanyak 8 dari 100.000 orang, dengan adenokarsinoma merupakan tipe kanker pankreas tersering. 5,18 Gambaran Makroskopik Pankreatitis Kronis Secara patologis, pankreatitis kronis dapat dilihat dari kombinasi adanya fibrosis, atrofi parenkim, dan patologi pada duktus. Pada tahap awal penyakit, pankreas dapat terlihat normal, tetapi akan mengeras di kemudian hari.…”