Risk of pancreatic cancer after acute pancreatitis: A population-based matched cohort study

Pancreatology. 2023 Aug;23(5):449-455. doi: 10.1016/j.pan.2023.05.001. Epub 2023 May 5.

Abstract

Background: We investigated the short- and long-term risks of pancreatic cancer after the diagnosis of acute pancreatitis.

Methods: This population-based matched-cohort study used data from the Korean National Health Insurance Service database. Patients with acute pancreatitis (n = 25,488) were matched with the control group (n = 127,440) based on age, sex, body mass index, smoking status, and diabetes. We estimated the hazard ratios for developing pancreatic cancer in both groups using Cox regression analysis.

Results: During a median follow-up of 5.4 years, pancreatic cancer developed in 479 patients (1.9%) in the acute pancreatitis group and 317 patients (0.2%) in the control group. Compared with the control group, the risk of pancreatic cancer in the acute pancreatitis group was very high within the first 2 years, which gradually decreased over time. The hazard ratio for the risk of developing pancreatitis was 8.46 (95% confidence interval, 5.57-12.84) at 1-2 years, and then decreased to 3.62 (95% confidence interval, 2.26-4.91) at 2-4 years. However, even after 8-10 years, the hazard ratio was still statistically significantly increased to 2.80 (95% confidence interval, 1.42-5.53). After 10 years, there was no significant difference in the risk of pancreatic cancer between the two groups.

Conclusions: The risk of pancreatic cancer increases rapidly after acute pancreatitis diagnosis, gradually declines after 2 years, and remains elevated for up to 10 years. Further studies are needed to determine the long-term effects of acute pancreatitis on the risk of pancreatic cancer.

Keywords: Acute pancreatitis; Pancreatic cancer; Risk assessment.

MeSH terms

  • Acute Disease
  • Cohort Studies
  • Humans
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / epidemiology
  • Pancreatitis* / complications
  • Pancreatitis* / epidemiology
  • Risk Adjustment
  • Risk Factors