Acute Pancreatitis Increases the Risk of Gastrointestinal Cancer in Type 2 Diabetic Patients: A Korean Nationwide Cohort Study

SIMPLE SUMMARY: The effect of acute pancreatitis on diabetic patients in terms of the occurrence of malignant tumors is not well understood. The main contribution of this study is to investigate the association between acute pancreatitis and gastrointestinal cancer in type 2 diabetic patients. Diabetic patients who had a history of acute pancreatitis showed a higher incidence of all gastrointestinal cancers, not only pancreatic cancer. The risk of gastrointestinal cancer in diabetic patients was increased by 1.6 to 4.5 times depending on the history of acute pancreatitis. It seems necessary to investigate the history of acute pancreatitis in diabetic patients and more actively recommend screening for gastrointestinal cancers in such patients. Results of this study suggest that proper management or prevention of acute pancreatitis might be important for diabetic patients. ABSTRACT: The association between acute pancreatitis (AP) and gastrointestinal cancers in diabetic patients is currently not well understood. The study aim was to investigate the association between AP and gastrointestinal cancers in diabetic patients. Data from the Korean National Health Insurance Service database were analyzed. Participants with diabetes who underwent a health examination between 2009 and 2012 were followed up till December 2018. The primary outcome was the occurrence of gastrointestinal cancer. A total of 2,263,184 patients were included in the final analysis. Patients with a history of AP (n = 2390) were found to have a significantly higher risk of gastrointestinal cancer, except for esophageal cancer, as follows: gastric cancer (aHR = 1.637, 95% CI: 1.323–2.025), colorectal cancer (aHR = 2.183, 95% CI: 1.899–2.51), liver cancer (aHR = 2.216, 95% CI: 1.874–2.621), pancreatic cancer (aHR = 4.558, 95% CI: 4.078–5.095), bile duct cancer (aHR = 3.996, 95% CI: 3.091–5.269), and gallbladder cancer (aHR = 2.445, 95% CI: 1.459–4.099). The history of AP is associated with the increased risk of gastrointestinal cancer in diabetic patients. It is necessary to investigate the history of AP and more actively recommend screening for gastrointestinal cancers in such patients.