Abstract
This study aimed to summarize published epidemiological evidence for the relationship between pancreatitis and subsequent risk of pancreatic cancer (PC). We searched Medline and Embase for epidemiological studies published by February 5th, 2014 examining the risk of PC in pancreatitis patients using highly inclusive algorithms. Information about first author, year of publication, country of study, recruitment period, type of pancreatitis, study design, sample size, source of controls and attained age of subjects were extracted by two researchers and Stata 11.0 was used to perform the statistical analyses and examine publication bias. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with the random effects model. A total of 17 articles documenting 3 cohort and 14 case-control studies containing 14,667 PC cases and 17,587 pancreatitis cases were included in this study. The pooled OR between pancreatitis and PC risk was 7.05 (95%CI: 6.42-7.75). However, the pooled ORs of case-control and cohort studies were 4.62 (95%CI: 4.08-5.22) and 16.3 (95%CI: 14.3-18.6) respectively. The risk of PC was the highest in patients with chronic pancreatitis (pooled OR=10.35; 95%CI: 9.13-11.75), followed by unspecified type of pancreatitis (pooled OR=6.41; 95%CI: 4.93-8.34), both acute and chronic pancreatitis (pooled OR=6.13; 95%CI: 5.00-7.52), and acute pancreatitis (pooled OR=2.12; 95%CI: 1.59-2.83). The pooled OR of PC in pancreatitis cases diagnosed within 1 year was the highest (pooled OR=23.3; 95%CI: 14.0-38.9); and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%CI: 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively. Pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC; and the risk decreased with increasing duration since diagnosis of pancreatitis.
Highlights
Pancreatic cancer (PC) has become one of the most serious diseases threatening human health and life all over the world
The pooled Odds ratios (ORs) of pancreatic cancer (PC) in pancreatitis cases diagnosed within 1 year was the highest; and the risk in subjects diagnosed with pancreatitis for no less than 2, 5 and 10 years were 3.03 (95%confidence intervals (CIs): 2.41-3.81), 2.82 (95%CI: 2.12-3.76) and 2.25 (95%CI: 1.59-3.19) respectively
Our study revealed that pancreatitis, especially chronic pancreatitis, was associated with a significantly increased risk of PC compared with non-pancreatitis
Summary
Pancreatic cancer (PC) has become one of the most serious diseases threatening human health and life all over the world. PC is less common than cancer of the lung, breast, colorectum, stomach and liver, etc., only ranked thirteenth (accounted for only 2.2%) of all new cancer cases; its mortality rate is quite high, ranked eighth (accounted for 3.5%) of all cancer deaths. Smokers have 2-fold to 3-fold increased risk of PC compared to non-smokers with cigarette smoking accounting for approximately a quarter of PC incidence (Howe et al, 1991; Silverman et al, 1994; Fuchs et al, 1996; Lowenfels et al, 2006; Ko et al, 2007; Bao et al, 2009; Talamini et al, 2010; Nitsche et al, 2011). Individuals with family history of PC, especially have first-degree relative(s) with PC, were consistently been found to be associated with added risk, and risk raised as the number of affected first-degree relative increased
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