The risk of pancreatic cancer following pancreatitis: An association due to confounding?

Karlson, BM; Ekbom, Anders; Josefsson, Staffan; Jk, McLaughlin; Fraumeni, JosephF.; Nyrén, Olof

doi:10.1053/gast.1997.v113.pm9247480

Cited by 171 publications

(114 citation statements)

References 3 publications

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“…In fact, the standardized incidence ratio was 26.3 (95% CI 19.9-34.2) for all patients, 16.5 (95% CI 11.1-23.7) for patients with two or more years of follow-up, and 14.4 (95% CI 8.5-22.8) for patients with five or more years of follow-up. These data have been confirmed in other reports [51,53,55,60]. We need further studies to reevaluate the real risk rate of pancreatic adenocarcinoma in patients with chronic pancreatitis.…”

Section: C4supporting

confidence: 79%

“…Cohort studies [52][53][54][55][56][57][58][59][60] confirmed the relationship between chronic pancreatitis and pancreatic cancer. It should be underlined that the findings of the cohort studies must be viewed in the light of potential methodological problems: first, the recruitment of patients began from 1946 to 1973 in most studies [53][54][55][56]59,60], when it was difficult to distinguish chronic pancreatitis from pancreatic cancer; second, cancer was not confirmed histologically in all patients evaluated; third, a number of patients may have had a slower-growing cancer, such as a cystadenocarcinoma or intraductal papillary neoplasia. Finally, the possible presence of a misclassification bias is well reported in the study of Lowenfels [56].…”

Section: C4mentioning

confidence: 96%

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Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

162

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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Section: C4supporting

confidence: 79%

Section: C4mentioning

confidence: 96%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

162

112

View full text Add to dashboard Cite

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“…Our study showed that 22.5% of pancreatic cancer patients had chronic pancreatitis while only 0.49% of control group did. Karlsen reported that the risk of pancreatic cancer increased 13 times from a follow-up investigation of 715 chronic pancreatitis patients for an average of 10 years during 1971 to 1995 [19] . At the same time, the author noticed that the incidence of pancreatic cancer was much higher than non-pancreatic tumors among those patients.…”

Section: Discussionmentioning

confidence: 99%

Establishment of risk model for pancreatic cancer in Chinese Han population

Lu¹,

Wang²,

Li³

et al. 2006

WJG

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AIM:To investigate risk factors for pancreatic cancer and establish a risk model for Han population. METHODS:This population-based case-control study was carried out from January 2002 to April 2004. One hundred and nineteen pancreatic cancer patients and 238 healthy people completed the questionnaire which was used for risk factor analysis. Logistic regression analysis was used to calculate odds ratio (ORs), 95% confidence intervals (Cls) and β value, which were further used to establish the risk model. RESULTS:According to the study, people who have smoked more than 17 pack-years had a higher risk to develop pancreatic cancer compared to non-smokers or light smokers (not more than 17 pack-years) (OR 1.98; 95% CI 1.11-3.49, P = 0.017). More importantly, heavy smokers in men had increased risk for developing pancreatic cancer (OR 2.11; 95%CI 1.18-3.78, P = 0.012) than women. Heavy alcohol drinkers (＞20 cup-years) had increased risk for pancreatic cancer (OR 3.68; 95%CI 1.60-8.44). Daily diet with high meat intake was also linked to pancreatic cancer. Moreover, 18.5% of the pancreatic cancer patients had diabetes mellitus compared to the control group of 5.8% (P = 0.0003). Typical symptoms of pancreatic cancer were anorexia, upper abdominal pain, bloating, jaundice and weight loss. Each risk factor was assigned a value to represent its importance associated with pancreatic cancer. Subsequently by adding all the points together, a risk scoring model was established with a value higher than 45 as being at risk to develop pancreatic cancer. CONCLUSION:Smoking, drinking, high meat diet and diabetes are major risk factors for pancreatic cancer. A risk model for pancreatic cancer in Chinese Han population has been established with an 88.9% sensitivity and a 97.6% specificity.

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“…About 30% of cases are attributable to smoking. 1,4 An increased frequency of pancreatic cancer has been suggested among individuals with a long-standing history of diabetes, 5,6 chronic pancreatitis, 7,8 pernicious anemia 9 and inheritable syndromes such as familial adenomatous polyposis. 10,11 An elevated risk of pancreatic cancer has also been seen in families with a history of breast cancer and BRCA2 mutations.…”

mentioning

confidence: 99%

Dietary patterns and risk of pancreatic cancer

Nkondjock

Krewski

Johnson

et al. 2005

Intl Journal of Cancer

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To investigate associations between broad dietary patterns and pancreatic cancer risk, we conducted a case-control study of 585 histologically confirmed pancreatic cancer cases and 4,779 population-based controls in 8 Canadian provinces between 1994 and 1997. Dietary intake was assessed using a FFQ. Major dietary patterns were identified by factor analysis. Unconditional logistic regression was used to describe associations between dietary pattern scores and risk of pancreatic cancer. Three dietary patterns were identified: Western, characterized by high intake of processed meats, sweets and desserts, refined grains and potatoes; fruits and vegetables, characterized by high intake of fresh fruits and cruciferous vegetables; drinker, characterized by high consumption of liquor, wine and beer. After adjustment for age, BMI, smoking, physical activity, province, educational attainment and total energy intake, the fruits and vegetables pattern was associated with a 49% reduction in pancreatic risk among men (OR ‫؍‬ 0.51, 95% CI 0. Because of its incidence and poor prognosis, pancreatic cancer is one of the most important human malignancies. Approximately 216,300 new cases occur worldwide each year. 1 In Canada in 2004, it is the fourth leading cause of cancer-related death in both men and women. 2 Survival is extremely low, with a 5-year rate of Ͻ5% 3 and a case-fatality ratio of 0.99. 2 Few risk factors for pancreatic cancer have been consistently identified. About 30% of cases are attributable to smoking. 1,4 An increased frequency of pancreatic cancer has been suggested among individuals with a long-standing history of diabetes, 5,6 chronic pancreatitis, 7,8 pernicious anemia 9 and inheritable syndromes such as familial adenomatous polyposis. 10,11 An elevated risk of pancreatic cancer has also been seen in families with a history of breast cancer and BRCA2 mutations. 12,13 It has been estimated that 30 -50% of pancreatic cancers may be due to dietary factors, 14 though for most dietary components the overall evidence is equivocal. A number of investigators have recorded a heightened risk in relation to excessive intake of fat, 15 grilled and salted/smoked red meats, 16,17 dairy products 18 and cholesterol, 19,20 though some of these associations were not confirmed in a large prospective cohort of women. 21 In contrast, pancreatic cancer risk has been found to decrease with increased consumption of fresh fruits and vegetables 20,22 as well as foods containing no preservatives or additives 19,20 and with increased carbohydrate and energy intake. 23 However, no studies to date have examined broader food consumption, which provides a more comprehensive representation of dietary intake involving a large number of dietary components working together. The present investigation was undertaken to explore the possible role of major dietary patterns in the etiology of pancreatic cancer within the Canadian NECSS. Material and methods Study populationThe NECSS is a multisite, population-based, case-control study involving ...

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The risk of pancreatic cancer following pancreatitis: An association due to confounding?

Cited by 171 publications

References 3 publications

Italian consensus guidelines for chronic pancreatitis

Italian consensus guidelines for chronic pancreatitis

Establishment of risk model for pancreatic cancer in Chinese Han population

Dietary patterns and risk of pancreatic cancer

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