Acute pancreatitis and the risk of pancreatic cancer

Abstract

Background: Pancreatic adenocarcinoma (PC) is an aggressive cancer with a dismal prognosis. Detection at early stage, when surgery is still possible, is essential to improve survival. To achieve this, knowledge on risk factors and populations at increased risk is needed. We investigated the association of acute pancreatitis (AP) with risk of PC. Methods: Using nationwide registries, we identified a cohort of all AP patients admitted to Danish hospitals during 1977-2012. For each patient, we identified up to five age- and sex-matched controls without AP. We excluded patients with chronic pancreatitis. Using Cox proportional hazards regression model, we computed hazard ratio (HR) for PC in patients with AP compared with the matched comparison cohort (MCC). HRs were adjusted for age, gallstone, Charlson Comobidity Index, alcohol- and smokingrelated diseases. Results: We identified 38,618 AP patients; 34,834 had a single admission for AP and 3,784 patients had more than one admission for AP. The MCC included 189,413 persons. Median age was 58.1 and 58.4 years in the AP group and MCC respectively; 52.3% of the study cohort were male. Median follow-up was 8.5 years. During follow-up, 117 pancreatic cancers occurred in the AP group (0.3%) and 643 in the MCC (0.3%). Adjusted HR of PC for patients with one attack of AP was 0.96 (95% CI: 0.76-1.22), and for recurrent AP 1.05 (95% CI: 0.59-1.87). Conclusion: Findings from our large population-based matched cohort study suggest that AP is not a risk factor for pancreatic cancer.