We read with great interest the recently published study on underlying pancreatic cancer (PC) in acute pancreatitis (AP). 1 Identifying underlying PC is important to reduce misdiagnosis. While, study design and statistical method could be improved a bit.First, excluding patients with chronic pancreatitis (CP) could make the study more accurate. CP and AP are two distinct diseases which differ in etiology, pathophysiology and nature course. AP episodes could present in course of CP which causes misdiagnosis. 2 Thus, AP patients with CP diagnosis probably already had CP misdiagnosed as AP at index date. Thus, the population in present study were actually composed of AP and CP patients. Since underlying PC exists in CP patients, inclusion of CP patients could lead to overestimation of incidence of underlying PC in AP patients. In present study, 1.00% (283/28,231) patients had been recognized as PC within one year of AP diagnosis, while the proportion was 0.69% (341/49,749) in a Swedish population-based study. 3 This verified the existence of overestimation of incidence for underlying PC. Therefore, CP patients should be excluded from the current study.Second, statistical method could be improved a bit. All variables in univariate analysis were included in multivariable model. Statistically, variables with insignificant P value (e.g., P > 0.05) in univariate model should be excluded in multivariable analysis to get better results. 4,5 In conclusion, the present study is meaningful as it might help clinicians to distinguish underlying PC in AP patients. While, study design and statistical method could be improved.