Background & Aims

Acute pancreatitis may be a risk factor for pancreatic cancer; however, findings from studies on this association are conflicting. We investigated the association between acute pancreatitis and increased risk of pancreatic cancer.

Methods

We conducted a nationwide, population-based, matched cohort study of all patients admitted to a hospital in Denmark with a diagnosis of acute pancreatitis from January 1, 1980, through October 31, 2012. As many as 5 individuals from the general population without acute pancreatitis were matched for age and sex to each patient with acute pancreatitis. Pancreatic cancer risk was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using the Cox proportional hazards model. Cox models were stratified by age, sex, and year of pancreatitis diagnosis and adjusted for alcohol- and smoking-related conditions, and Charlson Comorbidity Index score.

Results

We included 41,669 patients diagnosed with incident acute pancreatitis and 208,340 comparison individuals. Patients with acute pancreatitis had an increased risk of pancreatic cancer compared with the age- and sex-matched general population throughout the follow-up period. The risk decreased over time but remained high after more than 5 years of follow-up (adjusted HR 2.02; 95% CI 1.57–2.61). Two- and 5-year absolute risks of pancreatic cancer among patients with acute pancreatitis were 0.70% (95% CI 0.62%–0.78%) and 0.87% (95% CI 0.78%–0.97), respectively.

Conclusions

In a nationwide, population-based, matched cohort study, we observed an association between a diagnosis of acute pancreatitis and long-term risk of pancreatic cancer.

中文翻译：

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急性胰腺炎和胰腺癌的风险：丹麦全国性的队列研究

背景与目标

急性胰腺炎可能是胰腺癌的危险因素；但是，有关这种关联的研究结果却相互矛盾。我们调查了急性胰腺炎和胰腺癌风险增加之间的关联。

方法

我们对1980年1月1日至2012年10月31日在丹麦医院住院并诊断为急性胰腺炎的所有患者进行了基于人群的全国性队列研究。从普通人群中选出的5例无急性胰腺炎的患者胰腺炎在年龄和性别上均与每位急性胰腺炎患者匹配。胰腺癌风险表示为使用Cox比例风险模型计算的具有95％置信区间（CI）的风险比（HR）。根据年龄，性别和胰腺炎的诊断年份对Cox模型进行分层，并根据与酒精和吸烟相关的疾病以及Charlson合并症指数评分进行调整。

结果

我们纳入了41,669名被诊断为急性胰腺炎的患者和208,340名比较个体。在整个随访期间，与年龄和性别相匹配的普通人群相比，急性胰腺炎患者的胰腺癌风险增加。风险随着时间的流逝而降低，但在随访5年以上后仍然很高（校正后的HR 2.02； 95％CI 1.57–2.61）。急性胰腺炎患者的两年和五年胰腺癌绝对风险分别为0.70％（95％CI 0.62％–0.78％）和0.87％（95％CI 0.78％–0.97）。

结论

在一项基于人群的全国性队列研究中，我们观察到急性胰腺炎的诊断与胰腺癌的长期风险之间存在关联。