Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study

• Published in: Gut Vol. 67; no. 1; p. 138
• Main Authors: Kromrey, Marie-Luise, Bülow, Robin, Hübner, Jenny, Paperlein, Christin, Lerch, Markus M, Ittermann, Till, Völzke, Henry, Mayerle, Julia, Kühn, Jens-Peter
• Format: Journal Article
• Language: English
• Published: England 01-01-2018
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; Cholangiopancreatography, Magnetic Resonance; Disease Progression; Female; Follow-Up Studies; Germany - epidemiology; Humans; Incidence; Incidental Findings; Male; Middle Aged; Observer Variation; Pancreatic Cyst - diagnostic imaging; Pancreatic Cyst - epidemiology; Pancreatic Cyst - etiology; Pancreatic Cyst - pathology; Prevalence; Prognosis; Prospective Studies; Reproducibility of Results; Risk Factors; Sex Distribution; magnetic resonance imaging; pancreatic cancer; pancreatic tumors; pancreatic epidemiology; pancreas
• ISSN: 1468-3288
• DOI: 10.1136/gutjnl-2016-313127

To analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study.
A total of 1077 participants (521 men, mean age 55.8±12.8 years) of 2333 participants from the population-based Study of Health in Pomerania (SHIP) underwent magnetic resonance cholangiopancreaticography (MRCP) at baseline (2008-2012). MRCP was analysed for pancreatic cysts with a diameter ≥2 mm. 676/1077 subjects received a 5-year follow-up (2014-2016). The prevalence and incidence of pancreatic cysts (weighted for study participation) were assessed in association to age, gender and suspected epidemiological risk factors. Mortality follow-up was performed in 2015 for all SHIP participants (mean follow-up period 5.9 years, range 3.2-7.5 years).
At baseline pancreatic cysts had a weighted prevalence of 49.1%, with an average number of 3.9 (95% CI 3.2 to 4.5) cysts per subject in the subgroup harbouring cysts. Cyst size ranged from 2 to 29 mm. Prevalence (p<0.001), number (p=0.001) and maximum size (p<0.001) increased significantly with age. The 5-year follow-up revealed a weighted incidence of 12.9% newly detected pancreatic cysts. 57.1% of the subjects initially harbouring pancreatic cysts showed an increase in number and/or maximum cyst size. Of all subjects undergoing MRCP, no participant died of pancreatic diseases within mortality follow-up.
The prevalence of pancreatic cysts in the general population is unexpectedly high, and their number and size increase with age. Overall, no pancreatic cancer was observed in this collective during a 5-year follow-up. Nevertheless, prospective follow-up imaging showed minimal progress in more than 50%. Only about 6% of cysts and 2.5% of the study group initially presented with cysts of more than 1 cm and thus might be clinically meaningful.