The Epidemiology of Pancreatitis and Pancreatic Cancer

Yadav, Dhiraj; Lowenfels, Albert B.

doi:10.1053/j.gastro.2013.01.068

Cited by 1,649 publications

(1,464 citation statements)

References 111 publications

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“…It has been postulated that chronic pancreatitis is a major risk for the development of pancreatic cancer 1, 2. However, metabolic conditions such as obesity and diabetes mellitus (DM) have also been considered risk factors for pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

2017

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Background and AimNon‐alcoholic fatty pancreas disease (NAFPD) is a disease that ranges from simple steatosis and can further lead to chronic pancreatitis and possible pancreatic cancer development. Its exact pathogenesis and impact on clinical practice are still largely unknown. Pancreatic cancer is still the most lethal malignancy in the world. Studies about the relationship between NAFPD and pancreatic cancer are still lacking. This study aims to find the possible role of endoscopic ultrasound (EUS) examination as a screening tool in NAFPD patients based on EUS examination among pancreatic cancer patients.MethodsEUS hospital data were collected within a 2‐year period, and all patients who underwent EUS procedures were analyzed. Pancreatic malignancy was diagnosed based on imaging and tumor markers and cytopathology using the endoscopic ultrasound fine needle aspiration (EUS‐FNA) procedure. Patients with pre‐existing pancreatic diseases, significant alcohol consumption, or other primary cancer with metastasis to the pancreas were excluded. Statistical analysis was performed using SPSS version 23.0.ResultsIn total, 162 patients (75 females and 87 males) were recruited for database analysis.^ Pancreatic malignancy was found in 43 (26.5%) patients, whereas fatty pancreas was found in 53 (32.7%) patients, and this was commonly found among pancreatic cancer patients.^ Based on logistic regression analysis, factors such as age, gender, diabetes, and chronic pancreatitis were not found to be significant risk factors for pancreatic malignancy where fatty pancreas is the only significant risk factor for pancreatic cancer (odds ratio: 18.027 [95% CI: 7.288–44.588]).ConclusionPrevalence of NAFPD among pancreatic cancer patients is high. Future studies can be conducted to show whether EUS can be considered a screening tool for the early detection of pancreatic malignancy in NAFPD patients; a cohort prospective study might also be needed to show clear causality between fatty pancreas and pancreatic cancer.

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Section: Introductionmentioning

confidence: 99%

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

2017

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“…Chronic pancreatitis (CP) is a progressive, relapsing inflammatory disorder of the pancreas which often develops in the background of genetic susceptibility [1][2][3]. Mutations in the best characterized risk genes PRSS1 (cationic trypsinogen), SPINK1 (pancreatic secretory trypsin inhibitor), and CTRC (chymotrypsin C) stimulate activation of trypsinogen and result in elevated trypsin activity in the pancreas [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Genetic Analysis of Human Chymotrypsin-Like Elastases 3A and 3B (CELA3A and CELA3B) to Assess the Role of Complex Formation between Proelastases and Procarboxypeptidases in Chronic Pancreatitis

et al. 2017

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Human chymotrypsin-like elastases 3A and 3B (CELA3A and CELA3B) are the products of gene duplication and share 92% identity in their primary structure. CELA3B forms stable complexes with procarboxypeptidases A1 and A2 whereas CELA3A binds poorly due to the evolutionary substitution of Ala241 with Gly in exon 7. Since position 241 is polymorphic both in CELA3A (p.G241A) and CELA3B (p.A241G), genetic analysis can directly assess whether individual variability in complex formation might alter risk for chronic pancreatitis. Here we sequenced exon 7 of CELA3A and CELA3B in a cohort of 225 subjects with chronic pancreatitis (120 alcoholic and 105 non-alcoholic) and 300 controls of Hungarian origin. Allele frequencies were 2.5% for CELA3A p.G241A and 1.5% for CELA3B p.A241G in controls, and no significant difference was observed in patients. Additionally, we identified six synonymous variants, two missense variants, a gene conversion event and ten variants in the flanking intronic regions. Variant c.643-7G>T in CELA3B showed an association with alcoholic chronic pancreatitis with a small protective effect (OR = 0.59, 95% CI = 0.39-0.89, p = 0.01). Functional analysis of missense variants revealed no major defects in secretion or activity. We conclude that variants affecting amino-acid position 241 in CELA3A and CELA3B are not associated with chronic pancreatitis, indicating that changes in complex formation between proelastases and procarboxypeptidases do not alter pancreatitis risk.

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“…As for other cancers, fewer than 10 % of cases of pancreatic cancer occur among individuals younger than 55 years old, and the median age of onset is 71 years. In all groups, men have higher incidence rates than women [23]. Few if any, gender-specific hormonal risk factors seem to have a causal role in pancreatic cancer and that carcinoma of pancreas is an estrogen dependent tumor at least in part.…”

Section: Age Gender and Racementioning

confidence: 99%

Epidemiology of Pancreatic and Periampullary Cancer

Thapa

2015

Indian J Surg

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Pancreatic cancer is an important public health problem, although infrequent but with an exceptionally high mortality rate worldwide. Given that the majority of cancers occur in association with smoking, diabetes, pancreatitis, genetic factors, and others and with a growing population worldwide in mind, more cases would be expected in the near future giving further impetus to investigating prevention and treatment strategies to this international issue. The representative data on epidemiology of carcinoma of pancreas in India and Nepal are very poor. While there are many questions to be resolved, it is apparent that many facets of pancreatic cancer are becoming increasingly understood, and prospects for prevention are becoming apparent. Hence, screening research, recommendations, and implementation is an obvious priority. Although previous studies have contributed to the knowledge of carcinoma of pancreas epidemiology, such association needs to be further verified with proper epidemiological work. A new and global approach to the study of carcinoma of pancreas epidemiology is required if the disease prevention and treatment strategies are to be adequately directed and supported in the coming years. The collection and analysis of epidemiologic carcinoma of pancreas data will play a critical role in guiding future disease prevention strategies and optimizing patient management.

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The Epidemiology of Pancreatitis and Pancreatic Cancer

Cited by 1,649 publications

References 111 publications

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

Non‐alcoholic fatty pancreas disease as a risk factor for pancreatic cancer based on endoscopic ultrasound examination among pancreatic cancer patients: A single‐center experience

Genetic Analysis of Human Chymotrypsin-Like Elastases 3A and 3B (CELA3A and CELA3B) to Assess the Role of Complex Formation between Proelastases and Procarboxypeptidases in Chronic Pancreatitis

Epidemiology of Pancreatic and Periampullary Cancer

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