Chronic pancreatitis (CP) is driven by smoking, excessive alcohol use, and chronic inflammation – all known contributors to carcinogenesis. However, its association with malignancies beyond the pancreas remains underexplored. This study aimed to assess the frequency and spectrum of cancers in patients with CP. A retrospective cohort study was conducted at Nottingham University Hospitals of patients diagnosed with CP between 1 January 2006 and 31 December 2014, identified through a multisource case ascertainment strategy. Cancer frequencies were assessed in patients residing within Greater Nottingham. Age-adjusted standardised incidence ratios (SIRs) were calculated using national cancer incidence data from England as the reference population. Statistical analyses were performed using R (version 4.3.3). Of the 1003 CP patients identified, 678 resided in Greater Nottingham (median age at diagnosis 68 years (IQR 53–79); 66% male; 92% Caucasians. The median follow-up period was 7.3 years (IQR 2.8–11.6). Compared to the general population, patients with CP demonstrated significantly higher SIRs for upper respiratory tract (12.4; 95%CI 6.6–21.1; p < 0.0001), pancreatic (10.8; 95%CI 6.2–17.6; p < 0.0001), liver (8.8; 95%CI 2.4–22.6; p < 0.0001), lung (5.6; 95%CI 4.0–7.7; p < 0.0001), renal tract (4.8; 95%CI 2.7–7.9; p < 0.0001) oesophageal (4.8; 95%CI 1.8–10.4; p = 0.0001) and colorectal (2.5; 95%CI 1.4–4.2; p = 0.0009) cancers. CP confers a markedly elevated risk of both pancreatic and extra-pancreatic cancers. These findings hypothesise that CP might be a high-risk state for malignancy that could warrant proactive, risk-based cancer surveillance in this vulnerable population. • Chronic pancreatitis is associated with a significantly increased risk of both pancreatic and multiple extra-pancreatic cancers. • Highest excess risks were observed for upper respiratory tract, pancreatic, liver, lung, renal tract, oesophageal, and colorectal cancers. • Lung cancer was the most common malignancy and smoking increased lung cancer risk seven-fold.
Quammie et al. (Tue,) studied this question.