Objective To analyse the prevalence, incidence and clinical relevance of pancreatic cysts detected as incidental finding in a population-based longitudinal study.
Design 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).
Results 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.
Conclusion 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.
- pancreatic cancer
- pancreatic epidemiology
- pancreatic tumors
- magnetic resonance imaging
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Contributors J-PK, M-LK and RB conceptualised and planned the study. HV coordinated the SHIP study. J-PK, JH, CP and RB analysed the MR images. TI conducted the statistical analysis. J-PK, M-LK, JM and ML participated in discussions, and provided critical scientific input and analysis suggestions. M-LK, J-PK and JM wrote the manuscript.
Funding This work was supported by the Deutsche Krebshilfe/ Mildred-Scheel-Stiftung (109102), the Federal Ministry of Education and Research (BMBF GANI-MED 03IS2061A and BMBF 0314107, 01ZZ9603, 01ZZ0103, 01ZZ0403, 03ZIK012) and the European Union (EU-FP-7: EPC-TM).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional Review Board, University Medicine Greifswald.
Provenance and peer review Not commissioned; externally peer reviewed.
Correction notice This article has been corrected since it first published Online First. Errors in the spelling of the author list have been rectified.
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