Some Pancreatitis Patients May Want Cancer Screening

Pancreatic cancer tied to pancreatitis in study calling for increased screening of some older patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Spotting cancer early can increase the chances for successful treatment. But some cancers, such as pancreatic cancer, are rarely detected early. New research suggests another issue with the pancreas may signal cancer risk.

A team of researchers recently explored the connection between pancreatitis and pancreatic cancer.

These researchers found that a significant amount of pancreatic cancer patients had previously had pancreatitis, suggesting that some older pancreatitis patients should be screened for this type of cancer.

"Talk to your doctor about cancer screening."

According to the US National Library of Medicine, pancreatic cancer is often hard to treat because it is rarely identified early and tends to spread quickly.

This new study, which was led by Banke Agarwal, MD, of the Division of Gastroenterology and Hepatology at the Saint Louis University School of Medicine in Missouri, aimed to explore the risk of pancreatic cancer after acute pancreatitis — a sudden and temporary inflammation of the pancreas marked by abdominal pain, nausea and vomiting.

To do so, Dr. Agarwal and team looked at pancreatitis patients who were treated through the Veterans Health Administration from 1998 to 2007. Any patients who had previously had pancreatic cancer or had problems with recurrent pancreatitis were excluded from the study.

The participants were mostly male (89 percent) and had an average age of 56 years.

In looking at the records of 495,504 Veterans Health Administration patients, 5,720 cases of acute pancreatitis and 710 cases of pancreatic cancer were identified.

Of the 710 pancreatic cancer patients, 86 (12.1 percent) had pancreatitis at least once before being diagnosed with cancer.

The issues with pancreatitis occurred fairly recently prior to cancer diagnosis, as 76 patients (10.7 percent) had pancreatitis within the two years prior to their cancer diagnosis, and 69 patients (9.7 percent) had pancreatitis within one year of diagnosis.

In a news release from Saint Louis University Medical Center, Dr. Agarwal explained the significance of these findings.

"As a point of reference, it’s useful to consider that the relative number of patients with acute pancreatitis who are subsequently diagnosed with pancreatic cancer is greater than that of cancer discovered during colonoscopy screening," said Dr. Agarwal.

The risk for developing pancreatic cancer was highest in the first year after having pancreatitis. The risk then fell quickly as time went on.

The researchers noted that the pancreatic cancer risk was extremely slight in patients under the age of 40.

"To conclude, patients with [acute pancreatitis] after 40 years of age have an increased risk of [pancreatic cancer] diagnosis within the following 24 months," wrote Dr. Agarwal and team. "This would argue for a potential use of further diagnostic imaging with [endoscopic ultrasound] to diagnose underlying [pancreatic cancer]."

All participants in this study were drawn from Veterans Health Administration hospitals, and further research is needed to confirm these findings among a wider population.

"This is an interesting study with an impressive number of patients. However, based on the data, it is not justifiable to recommend screening for pancreatic cancer in all patients with acute pancreatitis," said Peter TW Kim, MD, MSc, FRCSC, Abdominal Transplant & Hepatopancreatobiliary Surgery Assistant Director, Living Donor Liver Transplantation Baylor University Medical Center at Dallas.

"Exceptions to this may include older patients with no identifiable cause of pancreatitis, or patients with a clinical picture that does not fit the typical features of pancreatitis. In these patients, we should have a low threshold for close follow-up and further imaging of the pancreas to assess for underlying pancreatic cancer," said Dr. Kim, who was not involved in this study.

"Due to its aggressive nature, any efforts to establish early diagnosis would be important in pancreatic cancer. However, recommending screening for all patients with acute pancreatitis is not warranted," he said.

This study was published online January 21 in the journal Clinical Gastroenterology and Hepatology. No conflicts of interest were reported.

Review Date: 
February 26, 2014
Last Updated:
March 3, 2014