Carewell Health William Beaumont Hospital Royal Oak, MI
Fady Banno, MD1, Abdellatif Ismail, MD2, Fatima Elmustafa, MBBS3, Ahmed Dirweesh, MD4, Ali Osman, MD, MSCI Candidate5, Mohammad Bilal, MD, FACG6, Mohamed Abdallah, MD7 1Carewell Health William Beaumont Hospital, Royal Oak, MI; 2University of Maryland, Baltimore, MD; 3Henry Ford Warren, Warren, MI; 4University of Minnesota Medical Center, Minneapolis, MN; 5Washington University School of Medicine in St. Louis, Ballwin, MO; 6University of Colorado Anschutz Medical Campus, Denver, CO; 7Corewell Health, Royal Oak, MI 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 US 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 (table 1), resulting in 189,342 patients in each cohort. Outcomes were assessed over a 10-year period starting one 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. Discussion: 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.
Figure: Table 1
Figure: Table 1
Disclosures: Fady Banno indicated no relevant financial relationships. Abdellatif Ismail indicated no relevant financial relationships. Fatima Elmustafa indicated no relevant financial relationships. Ahmed Dirweesh indicated no relevant financial relationships. Ali Osman indicated no relevant financial relationships. Mohammad Bilal: Boston Scientific – Consultant. Cook endoscopy – Paid speaker. Steris Endoscopy – Consultant. Mohamed Abdallah indicated no relevant financial relationships.
Fady Banno, MD1, Abdellatif Ismail, MD2, Fatima Elmustafa, MBBS3, Ahmed Dirweesh, MD4, Ali Osman, MD, MSCI Candidate5, Mohammad Bilal, MD, FACG6, Mohamed Abdallah, MD7. P4291 - Incidence of Pancreatic Cancer in Patients With Non-Alcohol-Associated Chronic Pancreatitis: A Multi-Center Cohort Study Using Real-World Data, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
