Zorisadday Gonzalez, MD1, Neel P. Roy, BSc2, Rajan Kanth, MD3, Praveen K. Roy, MD4
1Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX; 2Texas Tech University, Albuquerque, NM; 3WellSpan York Hospital, York, PA; 4Presbyterian Hospital, Albuquerque, NM
Introduction: Several studies have reported increased risk of pancreatic cancer in patients with chronic pancreatitis. However, the risk of pancreatic cancer in patients with a history of acute pancreatitis (AP) is not well known. Several recent epidemiological studies, especially case-control studies, have reported conflicting results. We conducted a meta-analysis of cohort studies to quantify the risk of pancreatic cancer in patients with history of AP.
Methods: A detailed search of several databases (Pubmed, Embase,Google Scholar, Cochrane database and CINAHL) and research scientific meetings of gastroenterology and surgical societies was performed for cohort studies examining the risk of pancreatic cancer in patients with a prior history of acute pancreatitis. Data was extracted using a standard form by 2 reviewers. Data regarding study characteristics, patient characteristics, exposures and outcomes and country of study was extracted. Summary odds ratio was calculated using Comprehensive Meta-analysis software. Random effects model was used for computing effect size. Studies without a matched control group were excluded. Heterogeniety and publication bias were assessed. Quality of studies was assessed using the Newscastle-Ottawa scale. There were no language restrictions
Results: Five cohort studies met the inclusion criteria. Studies were performed in UK, Sweden, USA and Taiwan. The most common etiology of AP was gall stone pancreatitis in all the studies. Patients with chronic pancreatitis and alcohol related acute pancreatitis were excluded in all studies.. All studies had a matched control group and adjusted for confounders. There were 1162 cases of pancreatic cancer in 103958 patients with a prior history of acute pancreatitis. 2042 cases of pancreatic cancer were seen in 1442158 controls. A higher risk of pancreatic cancer was seen among patients with prior history of AP ( OR 7.39: 95% CI 5.03-10.88, p< 0.05). Three studies provided data on risk of pancreatic cancer >2 years after diagnosis of AP. The risk of pancreatic cancer was still elevated after > 2 years in patients with prior of history of AP( OR 2.31: 1.61=3.30, p< 0.05). Heterogeneity was present and the effect size was computed using random effects model.
Discussion: Patients with a prior history of AP are at an increased risk of pancreatic cancer. Further cohort studies are needed to confirm these findings.
Citation: Zorisadday Gonzalez, MD; Neel P. Roy, BSc; Rajan Kanth, MD; Praveen K. Roy, MD. P0004 - RISK OF PANCREATIC CANCER IN PATIENTS WITH A PRIOR HISTORY OF ACUTE PANCREATITIS: META-ANALYSIS OF COHORT STUDIES. Program No. P0004. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.