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Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group.

Abstract

BACKGROUND

The results of case-control studies and anecdotal reports suggest that pancreatitis may be a risk factor for pancreatic cancer, but there have been no studies of sufficient size and power to assess the magnitude of the relation between these two diseases.

METHODS AND RESULTS

We undertook a multicenter historical cohort study of 2015 subjects with chronic pancreatitis who were recruited from clinical centers in six countries. A total of 56 cancers were identified among these patients during a mean (+/-SD) follow-up of 7.4 +/- 6.2 years. The expected number of cases of cancer calculated from country-specific incidence data and adjusted for age and sex was 2.13, yielding a standardized incidence ratio (the ratio of observed to expected cases) of 26.3 (95 percent confidence interval, 19.9 to 34.2). For subjects with a minimum of two or five years of follow-up, the respective standardized incidence ratios were 16.5 (95 percent confidence interval, 11.1 to 23.7) and 14.4 (95 percent confidence interval, 8.5 to 22.8). The cumulative risk of pancreatic cancer in subjects who were followed for at least 2 years increased steadily, and 10 and 20 years after the diagnosis of pancreatitis, it was 1.8 percent (95 percent confidence interval, 1.0 to 2.6 percent) and 4.0 percent (95 percent confidence interval, 2.0 to 5.9 percent), respectively.

CONCLUSIONS

The risk of pancreatic cancer is significantly elevated in subjects with chronic pancreatitis and appears to be independent of sex, country, and type of pancreatitis.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, New York Medical College, Valhalla 10595.

    , , , , , , ,

    Source

    The New England journal of medicine 328:20 1993 May 20 pg 1433-7

    MeSH

    Adult
    Case-Control Studies
    Chronic Disease
    Cohort Studies
    Confidence Intervals
    Europe
    Female
    Humans
    Incidence
    Male
    Middle Aged
    Pancreatic Neoplasms
    Pancreatitis
    Proportional Hazards Models
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    8479461

    Citation

    Lowenfels, A B., et al. "Pancreatitis and the Risk of Pancreatic Cancer. International Pancreatitis Study Group." The New England Journal of Medicine, vol. 328, no. 20, 1993, pp. 1433-7.
    Lowenfels AB, Maisonneuve P, Cavallini G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328(20):1433-7.
    Lowenfels, A. B., Maisonneuve, P., Cavallini, G., Ammann, R. W., Lankisch, P. G., Andersen, J. R., ... Domellöf, L. (1993). Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. The New England Journal of Medicine, 328(20), pp. 1433-7.
    Lowenfels AB, et al. Pancreatitis and the Risk of Pancreatic Cancer. International Pancreatitis Study Group. N Engl J Med. 1993 May 20;328(20):1433-7. PubMed PMID: 8479461.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. AU - Lowenfels,A B, AU - Maisonneuve,P, AU - Cavallini,G, AU - Ammann,R W, AU - Lankisch,P G, AU - Andersen,J R, AU - Dimagno,E P, AU - Andrén-Sandberg,A, AU - Domellöf,L, PY - 1993/5/20/pubmed PY - 1993/5/20/medline PY - 1993/5/20/entrez SP - 1433 EP - 7 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 328 IS - 20 N2 - BACKGROUND: The results of case-control studies and anecdotal reports suggest that pancreatitis may be a risk factor for pancreatic cancer, but there have been no studies of sufficient size and power to assess the magnitude of the relation between these two diseases. METHODS AND RESULTS: We undertook a multicenter historical cohort study of 2015 subjects with chronic pancreatitis who were recruited from clinical centers in six countries. A total of 56 cancers were identified among these patients during a mean (+/-SD) follow-up of 7.4 +/- 6.2 years. The expected number of cases of cancer calculated from country-specific incidence data and adjusted for age and sex was 2.13, yielding a standardized incidence ratio (the ratio of observed to expected cases) of 26.3 (95 percent confidence interval, 19.9 to 34.2). For subjects with a minimum of two or five years of follow-up, the respective standardized incidence ratios were 16.5 (95 percent confidence interval, 11.1 to 23.7) and 14.4 (95 percent confidence interval, 8.5 to 22.8). The cumulative risk of pancreatic cancer in subjects who were followed for at least 2 years increased steadily, and 10 and 20 years after the diagnosis of pancreatitis, it was 1.8 percent (95 percent confidence interval, 1.0 to 2.6 percent) and 4.0 percent (95 percent confidence interval, 2.0 to 5.9 percent), respectively. CONCLUSIONS: The risk of pancreatic cancer is significantly elevated in subjects with chronic pancreatitis and appears to be independent of sex, country, and type of pancreatitis. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/8479461/full_citation L2 - http://www.nejm.org/doi/full/10.1056/NEJM199305203282001?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -