An Updated Meta-analysis of Pancreatic Cancer Risk in Patients with Inflammatory Bowel Disease

This meta-analysis aims to systematically evaluate the relationship between inflammatory bowel disease (IBD) and the risk of developing pancreatic cancer (PC).

Systematic review and meta-analysis.

We searched PubMed (Medline), Web of Science, and Scopus up until September 8, 2024. To evaluate heterogeneity among the studies, we used the chi-square test and the I² statistic. An I² value exceeding 50% was considered indicative of substantial heterogeneity. We calculated estimates of odds ratios (OR), relative risks (RR), and hazard ratios (HR), along with their corresponding 95% confidence intervals (CI). The analysis was performed using a random-effects model. We established a significance level of less than 0.05 using Stata software, version 17.

We included a total of 17 studies in our analysis. Overall, patients with IBD showed a higher risk of developing PC, with an OR = 1.69 (95% CI: 1.48-1.93). Specifically, patients with Crohn's disease (CD) had an OR of 1.25 (95% CI: 1.10-1.41), while those with ulcerative colitis (UC) had an OR = 1.27 (95% CI: 1.10-1.45). Furthermore, patients with IBD accompanied by primary sclerosing cholangitis (PSC) displayed a significantly higher risk, with an OR = 3.12 (95% CI: 1.67-5.85). Additionally, there was no evidence of publication bias across all subgroups. Although there was no publication bias, we conducted a trim-and-fill analysis to investigate the small study effect. This analysis revealed that the results were influenced by omitted studies and that the pooled effects would be diluted if the omitted studies were included in the meta-analysis.

CD and UC are associated with an increased risk of PC, with no significant difference in risk levels between the two conditions. However, having IIBD along with PSC increases the risk of PC threefold.