CHRONIC PANCREATITIS AND PANCREATIC CANCER: A SLOW‐BURNING WICK OR AN EXPLOSIVE EVENT?

Sal Senzatimore, Jamie S. Barkin

Research output: Contribution to journalReview article

Abstract

Multiple studies have attempted to relate environmental factors to the development of pancreatic cancer. Tobacco use is the only risk factor strongly associated with pancreatic cancer in man and animal studies (1–4), whereas coffee consumption, gastric surgery for peptic ulcer disease, diabetes mellitus, and exposure to DDT are not proven risks (5, 6). It has been suggested that chronic pancreatitis plays a causal role in the development of pancreatic cancer. Ammann et al. (7) initially recognized this, in a longitudinal study that evaluated the course and outcome of patients with chronic pancreatitis. Seven of 245 patients developed pancreatic carcinoma over a 20‐yr period (8). Lowenfels et al. (9) conducted a multicenter, historical cohort study to define the association between chronic pancreatitis and pancreatic cancer. Centers from six countries provided 2,015 patients with chronic pancreatitis for the cohort. Of these patients, 1,552 were followed for greater than 2 yr and did not develop pancreatic cancer within the first 2 yr of follow‐up. Among the 1,552 subjects, 29 patients were eventually diagnosed with carcinoma, during a mean follow‐up of 7.4 yr. This resulted in a standardized incidence ratio (ratio of ohserved to expected) of 16.95. When subject followup was restricted to 5 yr or more, the incidence was calculated to he 14.4. The standardized incidence ratio when calculated, utilizing the original 2,015 patients, was 26.3. Lowenfels and colleagues concluded as follows: 1) that there was a strong association between chronic pancreatitis and pancreatic cancer evidenced hy a standardized incidence ratio of 16.95 in patients followed for two or more years, 2) that no difference in relative risk for pancreatic cancer existed, when alcoholic and non‐alcoholic causes of chronic pancreatitis were compared, and 3) that a multivariate analysis accounting for demographics, clinical findings, and lifestyle variables identifying increased age is the only relative risk factor for the development of pancreatic carcinoma.

Original languageEnglish (US)
Pages (from-to)1593-1594
Number of pages2
JournalThe American journal of gastroenterology
Volume89
Issue number9
DOIs
StatePublished - Sep 1994

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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