Fatty Pancreas Is a Risk Factor for Pancreatic Cancer: A Systematic Review and Meta-Analysis of 2956 Patients

SIMPLE SUMMARY: Pancreatic cancer (PC) is infamous for its silent and lethal nature, making it one of the leading causes of cancer-related deaths worldwide. The early detection of PC is critical to achieve a favorable prognosis, as it typically goes unnoticed until advanced stages. Fatty pancreas (FP) is often associated with PC, but the causal relationship has not been clearly defined. With this systematic review and meta-analysis, we aim to strengthen the connection and emphasize the potential risks of FP to the development of PC. Based on our analysis, our findings exhibit a clear risk of PC in the presence of FP, advocating for future prospective studies to be performed in order to solidify the relationship. ABSTRACT: Pancreatic cancer (PC) is one of the most lethal cancers worldwide. Recently, fatty pancreas (FP) has been studied thoroughly, and although its relationship to PC is not fully understood, FP is suspected to contribute to the development of PC. We aimed to assess the association between PC and FP by conducting a systematic review and meta-analysis. We systematically searched three databases, MEDLINE, Embase, and CENTRAL, on 21 October 2022. Case–control and cross-sectional studies reporting on patients where the intra-pancreatic fat deposition was determined by modern radiology or histology were included. As main outcome parameters, FP in patients with and without PC and PC in patients with and without FP were measured. Proportion and odds ratio (OR) with a 95% confidence interval (CI) were used for effect size measure. PC among patients with FP was 32% (OR 1.32; 95% CI 0.42–4.16). However, the probability of having FP among patients with PC was more than six times higher (OR 6.13; 95% CI 2.61–14.42) than in patients without PC, whereas the proportion of FP among patients with PC was 0.62 (95% CI 0.42–0.79). Patients identified with FP are at risk of developing PC. Proper screening and follow-up of patients with FP may be recommended.