Inflammatory Bowel Disease May Raise Risk of Pancreatic Cancer

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Updated: 9/27 1:00 am

May 5, 2010 -- People with inflammatory bowel disease -- especially men and those with ulcerative colitis -- may be at increased risk for developing pancreatic cancer, preliminary research suggests.

Up to 1 million Americans have inflammatory bowel disease (IBD); the main types are ulcerative colitis and Crohn's disease. The inner lining of the gastrointestinal tract becomes inflamed and damaged, causing abdominal pain, diarrhea (which may be bloody), weight loss, and rectal bleeding.

A few years ago, University of Utah researchers say they noticed that pancreatic cancer seemed to be developing at higher-than-normal rates in IBD patients and their family members.

To see if there was an association, the researchers studied 2,877 adults treated for IBD at the University of Utah Health System from January 1996 to December 2006. Their records were then compared with information from the Utah Cancer Registry and the Utah Population Database.

That way, they could figure out the rate of pancreatic cancer in the general population as well as the rate of pancreatic cancer in people with IBD and compare the two.

"We had striking and unexpected results," says Jason Schwartz, MD, assistant professor of surgery at the University of Utah.

"We thought there would be an association, but we were surprised at the strength of the association," he tells WebMD.

IBD Linked to Pancreatic Cancer: Study Results

Compared with what would be expected in the general population:

  • People with IBD had a 3.36-fold higher risk of pancreatic cancer.
  • People with ulcerative colitis had a 4.85-fold higher risk of pancreatic cancer.
  • Men with IBD had a 6.22-fold higher risk of pancreatic cancer.
  • Women with IBD did not appear to be at increased risk of pancreatic cancer.

There did not appear to be an association between Crohn's disease and pancreatic cancer.

The findings were presented at Digestive Disease Week 2010 in New Orleans.

IBD Linked to Pancreatic Cancer: Confirmation Needed

Schwartz says that theoretically, repeated bouts of inflammation in the intestinal tract have the potential to cause cancer.

Still, the study does not prove cause and effect. And the results need to be confirmed and upheld in a national study, he says.

Further studies also need to look at whether family members of people with IBD are at increased risk of pancreatic cancer, Schwartz says.

But if corroborated, the findings could open the door for new screening recommendations for pancreatic cancer in patients with IBD and their families, says Craig Fisher, MD, a pancreatic cancer surgeon at Methodist Hospital in Houston.

The goal, he tells WebMD, is earlier identification of pancreatic cancer.

"There will be about 38,000 new diagnoses of pancreatic cancer this year and about the same number of deaths," he says.

The reason the cancer carries such a high death rate, Fisher says, is because it is often diagnosed at a late stage when it can no longer be surgically removed.

"If we can pinpoint patients at higher risk, it could prove [cost-effective] to screen them," perhaps with endoscopic ultrasound or MRI, he says.

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