Prevalence of Extrapancreatic Cancers in Patients With Histologically Proven Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Case-Control Study

BACKGROUND: Some studies have suggested that intraductal papillary mucinous neoplasms (IPMN) of the pancreas could be associated with extrapancreatic cancers (EPC)-especially from gastric and colorectal origin. The aim of this case-control study was to examine the association of EPC in patients with histologically proven IPMN. PATIENTS: AND METHODS: A case-control study comparing 178 patients with resected IPMN (hyperplasia/low-grade dysplasia N = 91, high-grade dysplasia/invasive cancer N = 87) with 356 age- and gender-matched controls. EPC were searched for in patients with IPMN and controls, as well as familial histories of cancer and alcohol and tobacco intake. The prevalence and odds ratio were calculated. RESULTS: No difference was observed between alcohol and tobacco intake in IPMN patients and controls. EPC was found in 30 of 178 (16.8%) patients with IPMN (70% of which preceding IPMN) and in 30 of 356 (8.4%) controls (P = 0.003). The most frequent cancers in patients with IPMN and controls were: breast (30% in each group), prostate (10% and 13%, respectively, not significant [NS]), and colon/rectum (10 and 6%, respectively, NS). No correlation was found between the occurrence of EPC and the grade of IPMN. CONCLUSIONS: The prevalence of EPC in patients with IPMN is higher as compared with controls. The type and age at onset of EPC do not differ from the general population. Most of the EPCs precede the diagnosis of IPMN. A systematic screening of EPC should be performed only after the age of 50 yr or in case of a familial history of cancer, as yet recommended.