Prevalence, incidence of pancreatic cysts growing
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The diagnosis of patients with pancreatic cysts nearly doubled in the last 8 years, according to research presented at the American College of Gastroenterology Annual Scientific Meeting.
In his presentation, Adam Schweber, MD, of Columbia University Medical Center, said despite recent updates in cyst research, there is still much to discover about their basic epidemiology.
“Reported prevalences vary dramatically, from well under 1% to nearly 25%,” he said. “Our objective was to leverage the large sample sizes offered by real-world data to address two specific epidemiologic questions. Our first question; what is the prevalence of asymptomatic pancreatic cysts? Our second question; what is the magnitude of putative growth in cyst diagnosis over the last decade, and what might be driving this trend?”
Researchers used real-world data from the IBM Marketscan claims database to explore the prevalence of pancreatic cysts. Each year, they selected a study population of more than 17 million patients and defined prevalent cases as patients who received an ICD-9/10 diagnosis of cysts in that year. They defined incident cases as patients who lacked a cyst diagnosis in the preceding 2 years. Investigators also narrowed the study population to assess “real-world prevalence” by only including patients with imaging and no history of cysts or other pancreatic pathology.
Over the course of 8 years, the standardized cumulative incidence of pancreatic cysts grew from 6.3 per 10,000 in 2010 to 11.4 per 10,000 in 2017. Prevalence also grew, from 8.9 per 10,000 in 2010 to 18.7 per 10,000 in 2017.
Schweber said these rates could imply that 609,000 patients received a diagnosis of a pancreatic cysts in 2017, and 371,000 of those patients were newly diagnosed.
Additionally, the real-world prevalence of cysts was 2% among 722,000 patients who were diagnosed without prior history of cysts or pancreatic pathology. This prevalence indicated that an estimated 6.5 million patients in the United States have a pancreatic cyst, exceeding what is actually clinically diagnosed, Schweber said.
Prevalence of cysts increased exponentially with age until 65 years, and nearly 70% of patients with a cyst diagnosis were aged at least 55 years.
While the annual percent change in incidence was 8.7%, the annual percent change in abdominal imaging was only 2.6%.
“Contrary to what many have suggested, the upward trend in cyst diagnosis cannot be wholly attributed to the growth in imaging,” Schweber said. “Rather, growth in new cyst diagnoses far outpaced the growth in imaging.”
While he said more research is needed to explore the drivers of increased cyst diagnosis, Schweber said some potential factors could include increased awareness, increased billing for diagnosis or an increase in incident disease.
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Schweber A, et al. Abstract S0004. Presented at: The American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 26-28, 2020.
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