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Pancreatic Cancer Following Acute Pancreatitis: A Population-based Matched Cohort Study
Omid Sadr-Azodi1,1,1, Viktor Oskarsson1, Andrea Discacciati1
1Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Department of Surgery, Eskilstuna County Hospital, Eskilstuna, Sweden. Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Department of Surgery, Västerås County Hospital, Västerås, Sweden.
Acute pancreatitis may indicate pre-existing pancreatic cancer, with risk decreasing over time. Recurrent pancreatitis increases pancreatic cancer risk, suggesting chronic pancreatitis may mediate long-term associations.
Area of Science:
- Gastroenterology and Hepatology
- Oncology
- Epidemiology
Background:
- The relationship between acute pancreatitis and pancreatic cancer is complex and not fully understood.
- Investigating the temporal association is crucial for early cancer detection.
Purpose of the Study:
- To investigate the long-term association between acute pancreatitis and subsequent pancreatic cancer risk.
- To explore the influence of pancreatitis etiology and recurrence on this association.
Main Methods:
- Population-based cohort study of Swedish residents diagnosed with acute pancreatitis (1997-2013).
- Matched pancreatitis-free individuals for comparison.
- Multivariable Cox regression models to estimate hazard ratios.
Main Results:
- A significantly increased risk of pancreatic cancer was observed in the years following acute pancreatitis diagnosis.
- This risk declined over time, normalizing after more than 10 years.
- Non-gallstone-related pancreatitis showed a persistent increased risk, potentially mediated by recurrent or chronic pancreatitis.
Conclusions:
- Acute pancreatitis may present as a symptom of undiagnosed pancreatic cancer.
- Long-term associations for non-gallstone pancreatitis might be linked to recurrent or chronic pancreatitis development.
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