Korean J Fam Pract. 2018; 8(1): 147-150  https://doi.org/10.21215/kjfp.2018.8.1.147
Do Benign Pancreatic Cysts Increase the Incidence Risk of Pancreatic Cancer?: For Korean Aged over 40 Years
Yong-hwan Kim1, Yong-gwang Kim1, Yohan Jung1, Hyun-gyu Shin1, Mi-hye Kim1, Jaejun Dong2, Jae Yong Shim1, Duk-chul Lee1,*
1Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine; 2Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Duk-chul Lee
Tel: +82-2-2019-3483, Fax: +82-2-3463-3287
E-mail: FAITH@yuhs.ac
ORCID: http://orcid.org/0000-0001-9166-1813
Received: September 9, 2016; Revised: September 27, 2016; Accepted: October 2, 2016; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Whether pancreatic cysts such as mucinous cystic neoplasm and intraductal papillary mucinous neoplasm have malignant potential is known. However, whether patients with benign pancreatic cysts have a higher risk of pancreatic cancer (PaCa) has not been established yet.
Methods: We evaluated data from the National Health Insurance Service-National Sample Cohort (2002–2006) of the Korean National Health Insurance Service. Patients with pancreatic cysts detected on computed tomography/magnetic resonance imaging were identified using the Korean Classification of Diseases, 6th Edition. Patients aged >40 years with and those without pancreatic cystic lesions were followed up until 2010 (389,777 patients).
Results: During the study period, PaCa was diagnosed in 2 of 71 patients with pancreatic cysts and in 1,605 of 389,706 patients without pancreatic cyst. The incidence rates of PaCa were 2.82% and 0.41%, respectively. The hazard ratio of PaCa in all the patients with cysts was 9.839 (95% confidence interval, 2.461–39.332; P=0.0012) when compared with the rest of the patients without cysts.
Conclusion: Patients aged >40 years with pancreatic cysts have a significantly higher risk of PaCa.
Keywords: Pancreatic Cysts; Pancreatic Neoplasms; Incidence; Risk
References
  1. Statistics Korea. 2013, 61 cancer, by age, cancer incidence number, relative frequency, crude incidence rate, age-standardized incidence rate [Internet]. [cited 2015 Nov 20].
    Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A00025&vw_cd=&list_id=&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=K1&path=
  2. Korean National Cancer Information Center [Internet]. [cited 2015 Nov 20].
    Available from: https://www.cancer.go.kr/lay1/S1T645C646/contents.do
  3. Korean Ministry of Health and Welfare [Internet]. [cited 2015 Nov 20].
    Available from: https://www.cancer.go.kr/lay1/program/S1T211C221/cancer/view.do?cancer_seq=5117
  4. Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L. Pancreatic cysts:depiction on single-shot fast spin-echo MR images. Radiology 2002; 223:547-53.
    Pubmed CrossRef
  5. Adsay NV. Cystic neoplasia of the pancreas: pathology and biology. J Gastrointest Surg 2008; 12: 401-4.
    Pubmed CrossRef
  6. Parra-Herran CE, Garcia MT, Herrera L, Bejarano PA. Cystic lesions of the pancreas: clinical and pathologic review of cases in a five year period. JOP 2010; 11: 358-64.
    Pubmed
  7. Klibansky DA, Reid-Lombardo KM, Gordon SR, Gardner TB. The clinical relevance of the increasing incidence of intraductal papillary mucinous neoplasm. Clin Gastroenterol Hepatol 2012; 10: 555-8.
    Pubmed KoreaMed CrossRef
  8. Pelaez-Luna M, Chari ST, Smyrk TC, Takahashi N, Clain JE, Levy MJ, et al. Do consensus indications for resection in branch duct intraductal papillary mucinous neoplasm predict malignancy? A study of 147 patients. Am J Gastroenterol 2007; 102: 1759-64.
    Pubmed CrossRef
  9. Tang RS, Weinberg B, Dawson DW, Reber H, Hines OJ, Tomlinson JS, et al. Evaluation of the guidelines for management of pancreatic branch-duct intraductal papillary mucinous neoplasm. Clin Gastroenterol Hepatol 2008;6: 815-9.
    Pubmed CrossRef
  10. de Jong K, Nio CY, Hermans JJ, Dijkgraaf MG, Gouma DJ, van Eijck CH, et al. High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations. Clin Gastroenterol Hepatol 2010; 8: 806-11.
    Pubmed CrossRef
  11. Laffan TA, Horton KM, Klein AP, Berlanstein B, Siegelman SS, Kawamoto S, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol 2008; 191: 802-7.
    Pubmed KoreaMed CrossRef
  12. Simeone DM. SSAT/AGA/ASGE state of the art conference on cystic neoplasms of the pancreas. J Gastrointest Surg 2008; 12: 1475-7.
    Pubmed CrossRef
  13. Statistics Korea. 2013, 24 cancer, by gender/by age (by 5 yr age group) 5 yr cancer incidence number, Incidence rate [Internet]. [cited 2015 Nov 20].
    Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A00023&vw_cd=MT_ZTITLE&list_id=101_11744&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=E1
  14. Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, Yee J, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol 2010; 7: 754-73.
    Pubmed CrossRef
  15. Brook OR, Beddy P, Pahade J, Couto C, Brennan I, Patel P, et al. Delayed growth in incidental pancreatic cysts: are the current american college of radiology recommendations for follow-up appropriate? Radiology 2016; 278:752-61.
    Pubmed CrossRef
  16. Kimura W, Nagai H, Kuroda A, Muto T, Esaki Y. Analysis of small cystic lesions of the pancreas. Int J Pancreatol 1995; 18: 197-206.
    Pubmed
  17. Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology 2004; 126: 1330-6.
    Pubmed CrossRef
  18. Fernández-del Castillo C, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL. Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg 2003; 138: 427-3.
    Pubmed KoreaMed CrossRef
  19. Yamao K, Yanagisawa A, Takahashi K, Kimura W, Doi R, Fukushima N, et al. Clinicopathological features and prognosis of mucinous cystic neoplasm with ovarian-type stroma: a multi-institutional study of the Japan pancreas society. Pancreas 2011; 40: 67-71.
    Pubmed CrossRef
  20. Das A, Wells CD, Nguyen CC. Incidental cystic neoplasms of pancreas: what is the optimal interval of imaging surveillance? Am J Gastroenterol 2008;103: 1657-62.
    Pubmed CrossRef
  21. Walsh RM, Vogt DP, Henderson JM, Zuccaro G, Vargo J, Dumot J, et al. Natural history of indeterminate pancreatic cysts. Surgery 2005; 138: 665-70.
    Pubmed CrossRef
  22. Tanaka M, Chari S, Adsay V, Fernandez-del Castillo C, Falconi M, Shimizu M, et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology 2006; 6: 17-32.
    Pubmed CrossRef
  23. Tanaka M, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 2012; 12: 183-97.
    Pubmed CrossRef
  24. Munigala S, Gelrud A, Agarwal B. Risk of pancreatic cancer in patients with pancreatic cyst. Gastrointest Endosc 2016; 84: 81-6.
    Pubmed CrossRef

This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives