{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:30:34Z","timestamp":1792067434872,"version":"4.4.0"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can give rise to pancreatic cancer (PC). Limited population data exist on their prevalence, natural history, or risk of malignant transformation (IPMN-PC).<\/jats:p><\/jats:sec>Objective<\/jats:title>To fill knowledge gaps in epidemiology of IPMNs and associated PC risk by estimating population prevalence of IPMNs, associated PC risk, and proportion of IPMN-PC.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>:<\/jats:bold> This retrospective cohort study was conducted in Olmsted County, Minnesota. Using the Rochester Epidemiology Project (REP), patients aged 50 years and older with abdominal computed tomography (CT) scans between 2000 and 2015 were randomly selected (CT cohort). All patients from the REP with PC between 2000 and 2019 were also selected (PC cohort). Data were analyzed from November 2021 through August 2023.<\/jats:p><\/jats:sec>Main outcomes and Measures<\/jats:title>CIs for PC incidence estimates were calculated using exact methods with the Poisson distribution. Cox models were used to estimate age, sex, and stage\u2013adjusted hazard ratios for time-to-event end points.<\/jats:p><\/jats:sec>Results<\/jats:title>The CT cohort included 2114 patients (1140 females [53.9%]; mean [SD] age, 68.6 [12.1] years). IPMNs were identified in 231 patients (10.9%; 95% CI, 9.7%-12.3%), most of which were branch duct (210 branch-duct [90.9%], 16 main-duct [6.9%], and 5 mixed [2.2%] IPMNs). There were 5 Fukuoka high-risk (F-HR) IPMNs (2.2%), 39 worrisome (F-W) IPMNs (16.9%), and 187 negative (F-N) IPMNs (81.0%). After a median (IQR) follow-up of 12.0 (8.1-15.3) years, 4 patients developed PC (2 patients in F-HR and 2 patients in F-N groups). The PC incidence rate per 100 person years for F-HR IPMNs was 34.06 incidents (95% CI, 4.12-123.02 incidents) and not significantly different for patients with F-N IPMNs compared with patients without IPMNs (0.16 patients; 95% CI, 0.02-0.57 patients vs 0.11 patients; 95% CI, 0.06-0.17 patients; P<\/jats:italic>\u2009=\u2009.62). The PC cohort included 320 patients (155 females [48.4%]; mean [SD] age, 72.0 [12.3] years), and 9.8% (95% CI, 7.0%-13.7%) had IPMN-PC. Compared with 284 patients with non-IPMN PC, 31 patients with IPMN-PC were older (mean [SD] age, 76.9 [9.2] vs 71.3 [12.5] years; P<\/jats:italic>\u2009=\u2009.02) and more likely to undergo surgical resection (14 patients [45.2%] vs 60 patients [21.1%]; P<\/jats:italic>\u2009=\u2009.003) and more-frequently had nonmetastatic PC at diagnosis (20 patients [64.5%] vs 130 patients [46.8%]; P<\/jats:italic>\u2009=\u2009.047). Patients with IPMN-PC had better survival (adjusted hazard ratio, 0.62; 95% CI, 0.40-0.94; P<\/jats:italic>\u2009=\u2009.03) than patients with non-IPMN PC.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, CTs identified IPMNs in approximately 10% of patients aged 50 years or older. PC risk in patients with F-N IPMNs was low and not different compared with patients without IPMNs; approximately 10% of patients with PC had IPMN-PC, and they had better survival compared with patients with non-IPMN PC.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.37799","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T15:01:07Z","timestamp":1697554867000},"page":"e2337799","source":"Crossref","is-referenced-by-count":77,"title":["Long-Term Outcomes and Risk of Pancreatic Cancer in Intraductal Papillary Mucinous Neoplasms"],"prefix":"10.1001","volume":"6","author":[{"given":"Jaime","family":"de la Fuente","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Columbia University Irving Medical Center and the Vagelos College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash K.","family":"Nehra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake A.","family":"Kassmeyer","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rondell P.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nagayama","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip J.","family":"Schulte","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Doering","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M.","family":"Delgado","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhi Swaroop","family":"Vege","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh T.","family":"Chari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Texas MD Anderson, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shounak","family":"Majumder","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"issue":"9","key":"zoi231104r1","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1001\/jama.2019.11456","article-title":"Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016.","volume":"322","author":"Smith-Bindman","year":"2019","journal-title":"JAMA"},{"issue":"4","key":"zoi231104r2","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/j.cgh.2015.08.038","article-title":"Association between advances in high-resolution cross-section imaging technologies and increase in prevalence of pancreatic cysts from 2005 to 2014.","volume":"14","author":"Moris","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"zoi231104r3","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/j.surg.2012.05.033","article-title":"851 Resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital.","volume":"152","author":"Valsangkar","year":"2012","journal-title":"Surgery"},{"issue":"5","key":"zoi231104r4","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","article-title":"Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas.","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"issue":"51","key":"zoi231104r5","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005535","article-title":"Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals: large-scale, single-center cohort study.","volume":"95","author":"Chang","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"zoi231104r6","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1016\/j.gastha.2022.07.004","article-title":"Pancreatic cancer is more frequently early stage at diagnosis in surgically resected IPMNs with pre-operative surveillance.","volume":"1","author":"de la Fuente","year":"2022","journal-title":"Gastro Hep Adv"},{"issue":"6","key":"zoi231104r7","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1097\/XCS.0000000000000176","article-title":"Number of worrisome features and risk of malignancy in intraductal papillary mucinous neoplasm.","volume":"234","author":"Zelga","year":"2022","journal-title":"J Am Coll Surg"},{"issue":"1","key":"zoi231104r8","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1053\/j.gastro.2019.08.032","article-title":"Long-term risk of malignancy in branch-duct intraductal papillary mucinous neoplasms.","volume":"158","author":"Oyama","year":"2020","journal-title":"Gastroenterology"},{"issue":"5","key":"zoi231104r9","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1053\/j.gastro.2017.07.019","article-title":"Long-term risk of pancreatic malignancy in patients with branch duct intraductal papillary mucinous neoplasm in a referral center.","volume":"153","author":"Pergolini","year":"2017","journal-title":"Gastroenterology"},{"issue":"3","key":"zoi231104r10","doi-asserted-by":"publisher","first-page":"802","DOI":"10.2214\/AJR.07.3340","article-title":"Prevalence of unsuspected pancreatic cysts on MDCT.","volume":"191","author":"Laffan","year":"2008","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"zoi231104r11","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1148\/radiol.2016151650","article-title":"Pancreatic cysts in autosomal dominant polycystic kidney disease: prevalence and association with PKD2 gene mutations.","volume":"280","author":"Kim","year":"2016","journal-title":"Radiology"},{"issue":"1","key":"zoi231104r12","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.pan.2018.11.014","article-title":"Systematic review and meta-analysis: prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals.","volume":"19","author":"Zerboni","year":"2019","journal-title":"Pancreatology"},{"issue":"3","key":"zoi231104r13","doi-asserted-by":"publisher","first-page":"266","DOI":"10.4065\/71.3.266","article-title":"History of the Rochester Epidemiology Project.","volume":"71","author":"Melton","year":"1996","journal-title":"Mayo Clin Proc"},{"issue":"12","key":"zoi231104r14","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1016\/j.mayocp.2012.08.012","article-title":"History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.","volume":"87","author":"Rocca","year":"2012","journal-title":"Mayo Clin Proc"},{"issue":"10","key":"zoi231104r15","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1136\/gutjnl-2016-311615","article-title":"Fukuoka criteria accurately predict risk for adverse outcomes during follow-up of pancreatic cysts presumed to be intraductal papillary mucinous neoplasms.","volume":"66","author":"Mukewar","year":"2017","journal-title":"Gut"},{"issue":"2","key":"zoi231104r17","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"1","key":"zoi231104r18","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1136\/gutjnl-2016-313127","article-title":"Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study.","volume":"67","author":"Kromrey","year":"2018","journal-title":"Gut"},{"issue":"4","key":"zoi231104r19","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.pan.2015.05.461","article-title":"Estimation of the prevalence of asymptomatic pancreatic cysts in the population of San Marino.","volume":"15","author":"Zanini","year":"2015","journal-title":"Pancreatology"},{"issue":"5","key":"zoi231104r20","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1097\/01.sla.0000124299.57430.ce","article-title":"Cystic pancreatic neoplasms: observe or operate.","volume":"239","author":"Spinelli","year":"2004","journal-title":"Ann Surg"},{"issue":"4","key":"zoi231104r21","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1053\/j.gastro.2015.01.014","article-title":"American Gastroenterological Association technical review on the diagnosis and management of asymptomatic neoplastic pancreatic cysts.","volume":"148","author":"Scheiman","year":"2015","journal-title":"Gastroenterology"},{"issue":"10","key":"zoi231104r22","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1038\/ajg.2013.103","article-title":"Pancreatic cyst prevalence and the risk of mucin-producing adenocarcinoma in US adults.","volume":"108","author":"Gardner","year":"2013","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"zoi231104r23","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1097\/MPA.0b013e31812575df","article-title":"Survival and prognosis of invasive intraductal papillary mucinous neoplasms of the pancreas: comparison with pancreatic ductal adenocarcinoma.","volume":"36","author":"Woo","year":"2008","journal-title":"Pancreas"},{"issue":"3","key":"zoi231104r24","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1097\/00000658-200109000-00005","article-title":"Intraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopathologic entity.","volume":"234","author":"Sohn","year":"2001","journal-title":"Ann Surg"},{"issue":"4","key":"zoi231104r25","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1053\/j.gastro.2015.01.015","article-title":"American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts.","volume":"148","author":"Vege","year":"2015","journal-title":"Gastroenterology"},{"issue":"3","key":"zoi231104r26","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1007\/s10620-021-06923-5","article-title":"Pancreas cancer incidence and pancreas cancer-associated mortality are low in national cohort of 7211 pancreas cyst patients.","volume":"67","author":"Anand","year":"2022","journal-title":"Dig Dis Sci"},{"issue":"6","key":"zoi231104r27","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1016\/j.cgh.2015.11.013","article-title":"Low rates of malignancy and mortality in asymptomatic patients with suspected neoplastic pancreatic cysts beyond 5 years of surveillance.","volume":"14","author":"Kwong","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"zoi231104r16","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/978-3-319-40618-3_28","volume-title":"AJCC Cancer Staging Manual","author":"Kakar","year":"2017","edition":"8th ed"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2810772\/de_la_fuente_2023_oi_231104_1696951640.71379.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T15:01:11Z","timestamp":1697554871000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2810772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,17]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.37799","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,17]]}}}