Incidence of Pancreatic Cancer in Patients With Non-Alcoholic-Associated Chronic Pancreatitis: A Multi-Center Cohort Study Using Real-World Data

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

American Journal of Gastroenterology

Abstract

Introduction: Chronic pancreatitis (CP) is associated with long-term complications, including an elevated risk of pancreatic cancer (PC). While alcohol-related CP is a known risk factor for PC, the cancer risk associated with non-alcohol-associated chronic pancreatitis (NA-CP) is less well defined. This study aimed to assess the incidence of PC in patients with NA-CP using a national database. Methods: A retrospective cohort analysis was conducted using the TriNetX U.S. Collaborative Network, which includes de-identified electronic health records from 69 healthcare organizations. Adults (≥18 years) with a diagnosis of “other chronic pancreatitis” (ICD-10: K86.1) were included in the NA-CP cohort. This code encompasses non-alcoholic forms of chronic pancreatitis, including idiopathic, hereditary, obstructive, and autoimmune etiologies. Patients with a prior diagnosis of PC (ICD-10: C25.x) were excluded. A control cohort was defined by patients undergoing general adult medical examinations without abnormal findings (ICD-10: Z00.00). Propensity score matching was performed (1:1) to balance demographics and comorbidities, resulting in 189,342 patients in each cohort. Outcomes were assessed over a 10-year period starting 1 day after the index diagnosis. Results: Following exclusions, 179,042 NA-CP patients and 189,140 controls were included in the final analysis. PC was diagnosed in 7,609 NA-CP patients (4.2%) and 408 controls (0.2%). The risk ratio was 19.7 (95% CI: 17.8–21.8), and the odds ratio was 20.5 (95% CI: 18.6–22.7), both highly significant (P < 0.001). Kaplan-Meier survival analysis revealed a 10-year survival probability of 93.6% in the NA-CP cohort compared to 99.5% in controls, with a hazard ratio of 21.9 (95% CI: 19.8–24.2, P < 0.001). Median survival was not reached in either group. Median follow-up duration was 923 days for NA-CP patients and 1,335 days for controls. Conclusion: NA-CP is strongly associated with an increased risk of PC, with a nearly 20-fold elevation in risk compared to matched individuals without pancreatitis. These findings underscore the potential oncogenic impact of chronic pancreatic inflammation in non-alcoholic etiologies. Future studies incorporating clinical, serologic, and histologic data are needed to refine risk stratification and inform targeted surveillance strategies.

Volume

120

Issue

10S2

First Page

S45

Comments

American College of Gastroenterology Annual Meeting, October 24-25, 2025, Phoenix, AZ

Last Page

S45

DOI

10.14309/01.ajg.0001127312.17833.05

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