Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals

Abstract

Although incidental pancreatic cystic neoplasms are being diagnosed with increasing frequency, little is known about the accurate prevalence of pancreatic cysts in the general population. The aims of this study were to evaluate the crude prevalence rate of pancreatic cystic neoplasms in asymptomatic healthy adults, and calculate the age- and sex-adjusted nationwide prevalence rate.A total of 21,745 asymptomatic individuals who underwent abdominal computed tomography (CT) as a health screening examination were enrolled between 2003 and 2013 at the Seoul National University Hospital Healthcare System Gangnam Center. Nationwide population data of 2010 were collected from the National Statistical Office, Korea.Incidental pancreatic cystic neoplasms were found in 457 individuals whose mean age was 58.7 years. The types of neoplasms were reviewed by 2 separate designated radiologists and the final diagnosis was made as follows: intraductal papillary mucinous neoplasm: 376 (82%), serous cystic neoplasm: 19 (4%), mucinous cystic neoplasm: 7 (2%), and indeterminate cysts: 55 (12%). Eight cases underwent operation. The crude prevalence rate was 2.1% and the age- and sex-adjusted expected nationwide prevalence was 2.2%. The prevalence increased with age.Here, we reported the first large-scale study among the healthy population to find out the prevalence rate of pancreatic cystic neoplasms; the age- and sex-adjusted prevalence was 2.2%, and increased with age. Further investigations regarding the clinical implications of incidental pancreatic neoplasms are necessary.

Pancreatic Cystic Neoplasms: Different Types, Different Management, New Guidelines

“…The exact prevalence of the different PCN is not known. Studies which assessed the prevalence rate of asymptomatic PCN reported a prevalence of 2.2-2.6% with computed tomography (CT) [10,11,12,13] and a prevalence of 14-45% with magnetic resonance imaging (MRI) [13,14,15]. This risk increases with age [10,11,12].…”

Editorial: Management of the Small Asymptomatic Pancreatic Cyst: Somehow Along the Way We Forgot About the Patient

“…Radiographic studies using either computed tomography or magnetic resonance imaging have demonstrated that pancreatic cystic lesions can be found incidentally in ~2.5% of patients undergoing abdominal imaging (1)(2)(3). Although the vast majority of these small lesions are not currently sampled endoscopically by endoscopic ultrasound fi ne needle aspiration, a number of prior surgical series suggest that generally-in the absence of a history of acute or chronic pancreatitis-the majority of these cystic lesions are mucinous neoplasms primarily branch duct intraductal papillary mucinous neoplasms (4)(5)(6)(7).…”

Influence of the Histopathological Features of the Lesion on the Diagnostic Yield of Fine-Needle Aspiration Cytology of Pancreatic Solid Lesions

“…This tumor remains one of the most lethal malignant neoplasms in western countries and is among the leading causes of cancer mortality, despite its relatively low incidence [2, 3]. Recent reports describe an increase in the incidence of asymptomatic pancreatic nodules, both solid and cystic, that are incidentally discovered due to the widespread use of imaging studies for different medical conditions [4, 5]. However, this earlier detection has so far not translated into better survival rates, for still more than 50% of patients are diagnosed at metastatic nonresectable stages [6] and are not amenable to cure, despite recent advances in therapy.…”