title: Risk factors for intraductal papillary mucinous neoplasm (IPMN) of the pancreas: a multicentre case-control study.
abstract: OBJECTIVE
  To investigate environmental, personal, and hereditary risk factors associated with the occurrence of intraductal papillary mucinous neoplasms of the pancreas (IPMNs).
  
  
  METHODS
  Multicentre case-control study. Risk factors were identified from a questionnaire collecting data on family and medical history, and environmental factors. Cases were prevalent IPMNs seen at the participating units within an 18-month timeframe. Matched controls were enrolled alongside patients seen at outpatient clinics.
  
  
  RESULTS
  Three-hundred and ninety patients with IPMN and 390 matched controls (166 males, mean age 65 in each group) were enrolled. Of the IPMNs, 310 had branch-duct involvement and 80 main-duct involvement. The only cancer with a 1st degree family history significantly higher in IPMN was pancreatic ductal adenocarcinoma (PDAC) (5.4% vs. 1.5%). Previous history of diabetes (13.6% vs. 7.5%), chronic pancreatitis (CP) (3.1% vs. 0.3%), peptic ulcer (7.2% vs. 4.3%), and insulin use (4.9% vs. 1.1%) were all more frequent with IPMNs. Logistic regression multivariate analysis revealed that history of diabetes (odds ratio (OR): 1.79, confidence interval (CI) 95%: 1.08-2.98), CP (OR: 10.10, CI 95%: 1.30-78.32), and family histories of PDAC (OR: 2.94, CI 95%: 1.17-7.39) were all independent risk factors. However, when analysis was restricted to diabetics who had taken insulin, risk of IPMN became stronger (OR: 6.03, CI 95%: 1.74-20.84). The association with all these risk factors seemed stronger for the subgroup with main duct involvement.
  
  
  CONCLUSIONS
  A previous history of diabetes, especially with insulin use, CP, and family history of PDAC are all relevant risk factors for the development of IPMN. These results suggest an overlap between certain risk factors for PDAC and IPMN.
authors: Digestive and Liver Disease Unit, Faculty of Medicine and Psychology, Sapienza University of Rome at S. Andrea Hospital, Rome, Italy. gabriele.capurso@gmail.com
authors: Gabriele
authors: G
authors: Capurso
authors: Stefania
authors: S
authors: Boccia
authors: Roberto
authors: R
authors: Salvia
authors: Marco
authors: M
authors: Del Chiaro
authors: Luca
authors: L
authors: Frulloni
authors: Paolo Giorgio
authors: PG
authors: Arcidiacono
authors: Alessandro
authors: A
authors: Zerbi
authors: Raffaele
authors: R
authors: Manta
authors: Carlo
authors: C
authors: Fabbri
authors: Maurizio
authors: M
authors: Ventrucci
authors: Ilaria
authors: I
authors: Tarantino
authors: Matteo
authors: M
authors: Piciucchi
authors: Antonella
authors: A
authors: Carnuccio
authors: Ugo
authors: U
authors: Boggi
authors: Emanuele
authors: E
authors: Leoncini
authors: Guido
authors: G
authors: Costamagna
authors: Gianfranco
authors: G
authors: Delle Fave
authors: Raffaele
authors: R
authors: Pezzilli
authors: Claudio
authors: C
authors: Bassi
authors: Alberto
authors: A
authors: Larghi
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology* / Q000235:genetics; D000231:Adenocarcinoma, Papillary / Q000453:epidemiology* / Q000235:genetics; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000235:genetics; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D026121:Indole Alkaloids; D007328:Insulin / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000235:genetics; D050500:Pancreatitis, Chronic / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D026121:Indole Alkaloids; D007328:Insulin; C488270:conicamin