title: Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas.
abstract: BACKGROUND
  The objectives of this study are to estimate prevalence and incidence of extrapancreatic malignancies (EPMs) among intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, and to identify risk factors for their occurrence.
  
  
  METHODS
  We conducted multicentric cohort study in Italy from January 2010 to January 2011 including 390 IPMN cases. EPMs were grouped as previous, synchronous (both prevalent) and metachronous (incident). We calculated the observed/expected (O/E) ratio of prevalent EPMs, and compared the distribution of demographic, medical history and lifestyle habits.
  
  
  RESULTS
  Ninety-seven EPMs were diagnosed in 92 patients (23.6%), among them 78 (80.4%) were previous, 14 (14.4%) were synchronous and 5 (5.2%) were metachronous. O/E ratios for prevalent EPMs were significantly increased for colorectal carcinoma (2.26; CI 95% 1.17-3.96), renal cell carcinoma (6.00; CI 95% 2.74-11.39) and thyroid carcinoma (5.56; CI 95% 1.80-12.96). Increased age, heavy cigarette smoking, alcohol consumption and first-degree family history of gastric cancer are significant risk factors for EPMs, while first-degree family history of colorectal carcinoma was borderline.
  
  
  CONCLUSIONS
  We report an increased prevalence of EPMs in Italian patients with IPMN, especially for colorectal carcinoma, renal cell and thyroid cancers. A systematic surveillance of IPMN cases for such cancer types would be advised.
authors.affiliation: Digestive Endoscopy Unit.
authors.forename: A
authors.initials: A
authors.lastname: Larghi
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Faculty of Medicine, University of Belgrade, Belgrade; University Clinical-Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia.
authors.forename: N
authors.initials: N
authors.lastname: Panic
authors.affiliation: Digestive and Liver Disease Unit, University 'Sapienza', Rome.
authors.forename: G
authors.initials: G
authors.lastname: Capurso
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Leoncini
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Arzani
authors.affiliation: Department of Surgery, University of Verona, Verona.
authors.forename: R
authors.initials: R
authors.lastname: Salvia
authors.affiliation: Department of Surgery, University of Pisa, Pisa.
authors.forename: M
authors.initials: M
authors.lastname: Del Chiaro
authors.affiliation: Department of Gastroenterology, University of Verona, Verona.
authors.forename: L
authors.initials: L
authors.lastname: Frulloni
authors.affiliation: Department of Gastroenterology & Gastrointestinal Endoscopy, San Raffaele Hospital, Milano.
authors.forename: P G
authors.initials: PG
authors.lastname: Arcidiacono
authors.affiliation: Pancreatic Surgery Section, Istituto Humanitas, Milano.
authors.forename: A
authors.initials: A
authors.lastname: Zerbi
authors.affiliation: Department of Gastroenterology, S. Agostino Hospital, Modena.
authors.forename: R
authors.initials: R
authors.lastname: Manta
authors.affiliation: Department of Gastroenterology, Bellaria Maggiore Hospita, Bologna.
authors.forename: C
authors.initials: C
authors.lastname: Fabbri
authors.affiliation: Department of Internal Medicine, University of Bologna, Bologna.
authors.forename: M
authors.initials: M
authors.lastname: Ventrucci
authors.affiliation: Department of Endoscopy, Ismet, Palermo.
authors.forename: I
authors.initials: I
authors.lastname: Tarantino
authors.affiliation: Digestive and Liver Disease Unit, University 'Sapienza', Rome.
authors.forename: M
authors.initials: M
authors.lastname: Piciucchi
authors.affiliation: Digestive Endoscopy Unit.
authors.forename: A
authors.initials: A
authors.lastname: Carnuccio
authors.affiliation: Department of Surgery, University of Pisa, Pisa.
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.affiliation: Digestive Endoscopy Unit.
authors.forename: G
authors.initials: G
authors.lastname: Costamagna
authors.affiliation: Digestive and Liver Disease Unit, University 'Sapienza', Rome.
authors.forename: G
authors.initials: G
authors.lastname: Delle Fave
authors.affiliation: Department of Internal Medicine, University of Bologna, Bologna.
authors.forename: R
authors.initials: R
authors.lastname: Pezzilli
authors.affiliation: Department of Surgery, University of Verona, Verona.
authors.forename: C
authors.initials: C
authors.lastname: Bassi
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade; University Clinical-Hospital Center 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia; Department of Gastroenterology, University Clinical Hospital 'Santa Maria della Misericordia', Udine.
authors.forename: M
authors.initials: M
authors.lastname: Bulajic
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; IRCCS San Raffaele Pisana, Rome, Italy. Electronic address: sboccia@rm.unicatt.it.
authors.forename: S
authors.initials: S
authors.lastname: Boccia
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology*; D002291:Carcinoma, Papillary / Q000453:epidemiology*; D002292:Carcinoma, Renal Cell / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology
keywords: IPMN; epidemiology; extrapancreatic malignancies; risk factors