Risk of Pancreatic Cancer Associated With Precursor Lesions in Individuals and First-Degree Relatives: A Nationwide Cohort Study

作者：Jonas F. Ludvigsson, Jiangwei Sun, Chen Yuan, Miroslav Vujasinović, Johannes-Matthias Löhr, Brian M. Wolpin, Qiao-Li Wang · 发表于：Clinical Gastroenterology and Hepatology · 年份：2026 · DOI：10.1016/j.cgh.2026.06.009 · 研究领域：Pancreatic and Hepatic Oncology Research、Pancreatitis Pathology and Treatment、Multiple and Secondary Primary Cancers

BACKGROUND & AIMS: The aim of this study was to evaluate the risk of pancreatic cancer in individuals with pathologically confirmed precursor lesions-including pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms, and mucinous cystic neoplasia-and their first-degree relatives. METHODS: Using nationwide population-based cohort study, we included all histopathologically diagnosed pancreatic precursors during 1981 to 2017 and up to 5 matched general population references in Sweden, and their first-degree relatives. Participants were followed through January 1st, 2020. Incidence rates and 95% confidence intervals were computed with the Poisson model, and hazard ratios were calculated using Cox proportional hazards regression. RESULTS: We identified 3980 index participants (681 precursor patients and 3299 reference individuals) and 25,986 first-degree relatives. Twenty-four index participants and 136 first-degree relatives developed pancreatic cancer during follow-up. Compared with reference individuals, precursor patients had a 7.25-fold (95% confidence interval, 2.13-24.71) higher risk of pancreatic cancer, corresponding to 330 per 100,000 person-years (95% confidence interval, 191-568) in precursors vs 40 per 100,000 person-years (95% confidence interval, 22-71) in reference individuals, with a particularly high incidence of pancreatic cancer in participants with pancreatic intraepithelial neoplasia (785 per 100,000 person-years; 95% confidence interva...