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Clin Gastroenterol Hepatol. 2014 Jul;12(7):1143-1150.e1. doi: 10.1016/j.cgh.2013.12.033. Epub 2014 Jan 16.

Increased risk of pancreatic adenocarcinoma after acute pancreatitis.

Author information

1
Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St Louis, Missouri.
2
Veterans Affairs, St Louis Health Care System, St Louis, Missouri; Department of Biostatistics, Saint Louis University School of Public Health, St Louis, Missouri.
3
Veterans Affairs, St Louis Health Care System, St Louis, Missouri; Department of Family and Community Medicine, Saint Louis University School of Medicine, St Louis, Missouri.
4
Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St Louis, Missouri. Electronic address: agarwalb@slu.edu.

Abstract

BACKGROUND & AIMS:

Acute pancreatitis (AP) is often the initial presentation of pancreatic cancer (pancreatic adenocarcinoma [PaCa]). We evaluated the risk of PaCa after AP.

METHODS:

We performed a retrospective study of patients with AP who sought care in the Veterans Health Administration from 1998 through 2007. We excluded patients with pre-existing PaCa or recurrent AP and those who had the first episode of acute pancreatitis, from 1998 through 2000.

RESULTS:

Of 495,504 patients with Veterans Health Administration inpatient and outpatient records, 5720 were diagnosed with AP (1.15%) and 710 were diagnosed with PaCa (0.14%), from 2000 through 2007. Seventy-six patients had AP within 2 years before being diagnosed with PaCa (10.7% of all patients with cancer diagnosed during that period). The risk for PaCa was greatest in the first year after AP (14.5 per 1000 patient-years) and then decreased rapidly. Risk for PaCa was negligible in patients <40 years old. The incidence of PaCa within the first year after AP was 7.69 per 1000 patient-years in fifth decade of life and reached 28.67 after the seventh decade. Time to diagnosis of PaCa after AP was ≤2 months for 34 patients, 3-12 months for 35 patients, 13-24 months for 7 patients, and >24 months for 10 patients.

CONCLUSIONS:

A significant number of patients with PaCa initially present with AP; the diagnosis of cancer is often delayed by up to 2 years. We suggest that PaCa be routinely considered as a potential etiology of AP in patients ≥40 years old.

KEYWORDS:

Acute Pancreatitis; Cancer Risk; Early Diagnosis; Pancreatic Cancer

PMID:
24440214
DOI:
10.1016/j.cgh.2013.12.033
[Indexed for MEDLINE]
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