High incidence of extrapancreatic carcinoma in chronic pancreatitis.

In the prospective clinical long-term study of 246 patients with chronic pancreatitis, 26 patients (24 men) developed 27 histologically proved malignant tumors (11%). Four additional patients with neoplasia were excluded (papilloma, two; Bowen's disease of the tonsils, one; and seminoma, one, occurring 8 years before onset of pancreatitis). In six patients pancreatic cancer was diagnosed (2.4%), which indicates a slightly increased risk over the general population. Interestingly, 21 patients developed extrapancreatic cancer (8.5%), including a very high incidence that has not been noted previously. The cancers were located in the oral cavity (in six), larynx (three), bronchus (eight), and gastrointestinal tract (four). The data suggest a causal relationship between chronic pancreatitis and cancer. As possible factors, smoking, alcohol abuse, diabetes, malnutrition, immune deficiency, and high dietary fat intake are discussed. There is, however, no definite evidence for any single known factor.