Gastrointestinal cancer precursor risk and mortality in pancreatic intraductal papillary mucinous neoplasms: a nationwide cohort study

Figures & data

Figure 1. Flow chart of patients – subject disposition.

Figure 2. Number of cases (IPMN) per calendar year. IPMN: intraductal papillary mucinous neoplasm.

Table 1. Baseline characteristics of study cohort.

	Case n = 117	Control n = 539
Gender
Male, n (%)	61 (52)	285 (53)
Female, n (%)	56 (48)	254 (47)
Age (yrs)
Mean (SD)	68.3 (8.0)	68.2 (7.7)
Median (IQR)	69.0 (64.0–73.0)	68.0 (64.0–73.0)
Range, min-max	41.0–87.0	40.0–87.0
Age, n (%) (yrs)
<50	2 (2)	9 (2)
50–69	63 (54)	292 (54)
70+	52 (44)	238 (44)
Country of birth, n (%)
Nordic	107 (91)	480 (89)
Other	10 (9)	59 (11)
Missing	0 (0)	0 (0)
Level of education, n (%)
Compulsory school, < = 9 yrs	29 (25)	160 (30)
Upper secondary school, 10–12 yrs	54 (46)	223 (41)
College or university, > = 13 yrs	34 (29)	150 (28)
Missing	0 (0)	6 (1)
Start year of follow-up
2000–2009	18 (15)	81 (15)
2010–2016	99 (85)	458 (85)
N in/out visits/admissions for 365 days prior to diagnosis or matching, n (%)
0	0 (0)	283 (53)
1	1 (1)	86 (16)
2	2 (2)	52 (10)
3+	114 (97)	118 (22)
Charlson Comorbidity Index, n (%)
0	31 (27)	350 (65)
1	24 (21)	80 (15)
2	28 (24)	51 (9)
> =3	33 (28)	58 (11)
Prior inflammatory bowel disease, n (%)	4 (3.4)	0 (0.0)
Prior cardiovascular disease, n (%)	9 (7.7)	31 (5.8)
Prior cancer, n (%)	29 (24.8)	49 (9.1)
Prior respiratory disease, n (%)	29 (24.8)	32 (5.9)
Diabetes, n (%)	9 (7.7)	15 (2.8)
Chronic obstructive pulmonary disease (COPD), n (%)	3 (2.6)	4 (0.7)
Obesity/dyslipidemia, n (%)	14 (12.0)	17 (3.2)
Alcohol-related disease, n (%)	5 (4.3)	4 (0.7)

Baseline comorbidities are defined as any hospital contact within 5 years prior to index.

SD: standard deviation; IQR: interquartile range; yrs: years; n: number of patients.

Table 2. Description of events (GI cancer precursors) among the study population.

	Case n = 117	Control n = 539
Follow-up time (yrs)
Mean (SD)	3.1 (2.4)	3.5 (2.7)
Median (IQR)	2.1 (1.1–4.9)	2.4 (1.2–4.8)
Range, min–max	0.5–10.0	0.5–12.7
Events within 30 days, n (%)	0 (0.0)	0 (0.0)
Events within 90 days, n (%)	0 (0.0)	0 (0.0)
Events within 365 days, n (%)	2 (1.7)	1 (0.2)
Events anytime, n (%)	2 (1.7)	4 (0.7)

SD: standard deviation; IQR: interquartile range; yrs: years; n: number of patients; GI: gastrointestinal.

Figure 3. Cumulative incidence curves for GI precursor lesions and all-cause mortality in patients with IPMN compared to controls. IPMN: intraductal papillary mucinous neoplasm; GI: gastrointestinal.

Table 3. Risk of all-cause and cause-specific mortality in patients with IPMN and matched general population comparators (Cox model).

	GI cancer precursors		All-cause mortality
	Case	Control	Case	Control
N	117	539	117	539
Events, n (%)	2 (1.71%)	4 (0.74%)	31 (26.50%)	69 (12.80%)
Follow-up years
Mean (SD)	3.11 (2.43)	3.51 (2.72)	3.13 (2.42)	3.54 (2.74)
Median (IQR)	2.10 (1.12–4.88)	2.42 (1.25–4.80)	2.12 (1.17–4.88)	2.47 (1.26–4.88)
Incidence rate/1000 PY (95% CI)	5.50 (0.67–19.87)	2.11 (0.58–5.41)	84.65 (57.51–120.15)	36.13 (28.11–45.72)
Hazard ratio (95% CI)
Unadjusted	2.48 (0.45–13.52)		2.95 (1.90–4.58)
Stratified	1.89 (0.34–10.55)		3.61 (1.79–7.27)

Stratified: Stratified analysis on matched strata.

PY: person-years; SD: standard deviation; IQR: interquartile range; yrs: years; n: number of patients; GI: gastrointestinal.

Table 4. Description of deaths among the study population.

	Case n = 117	Control n = 539
Follow-up time (yrs)
Mean (SD)	3.1 (2.4)	3.5 (2.7)
Median (IQR)	2.1 (1.2–4.9)	2.5 (1.3–4.9)
Range, min–max	0.5–10.0	0.5–12.7
Deaths within 30 days, n (%)	0 (0.0)	0 (0.0)
Deaths within 90 days, n (%)	0 (0.0)	0 (0.0)
Deaths within 365 days, n (%)	5 (4.3)	3 (0.6)

SD: standard deviation; IQR: interquartile range.

Data sharing statement

Other researchers can apply for our data through the different Swedish pathology departments, and through the Swedish National Board of Health and Welfare.