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Prevalence and Size-Based Risk Categorization of Pancreatic Cysts Among Asymptomatic Individuals With Screening MRI.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Radiology

Background:

  • Pancreatic cystic lesions (PCLs) are precursors to pancreatic cancer, but their prevalence and risk factors in the general population are unknown.
  • Current guidelines for resection focus on cyst size and high-risk features, often based on data from symptomatic patients.

Purpose of the Study:

  • To determine the prevalence of PCLs in an asymptomatic North American cohort.
  • To categorize PCLs by size-based risk.
  • To identify demographic factors and exposures associated with PCL development.

Main Methods:

  • A cross-sectional study analyzed data from 21,651 asymptomatic individuals undergoing whole-body MRI screening.
  • Radiologists interpreted scans using standardized templates, with free-text reports analyzed for PCLs.
  • Data included participant demographics and lifestyle exposures.

Main Results:

  • The prevalence of PCLs was 6.3% (age- and sex-standardized), increasing with age, reaching 20.8% in individuals 80 years or older.
  • Most PCLs (96.0%) were less than 2 cm; only 1.1% were 3 cm or larger.
  • Independent risk factors included older age (≥65 years), female sex, history of pancreatitis or pancreatic cancer, family history of pancreatic cancer, alcohol consumption, and certain ethnicities.

Conclusions:

  • Incidental PCLs are common in asymptomatic individuals, particularly older adults.
  • The majority of PCLs identified are small and likely low-risk.
  • Identifying risk factors like age, sex, personal/family history, and ethnicity is crucial for risk stratification.