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World J Gastrointest Surg. Oct 27, 2010; 2(10): 314-318
Published online Oct 27, 2010. doi: 10.4240/wjgs.v2.i10.314
Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients
Saboor Khan, Guido Sclabas, Kaye M Reid-Lombardo
Saboor Khan, Guido Sclabas, Kaye M Reid-Lombardo, Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Khan S, Sclabas G and Reid-Lombardo KM took part in drafting the manuscript and critical revision of the manuscript for important intellectual content; Reid-Lombardo KM also provided the administrative, technical, and material support as well as supervision through the manuscript process; and Reid-Lombardo KM is the author that holds the funding that provided the opportunity for this work.
Supported by Grant Number 1 UL1 RR024150 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research.
Correspondence to: Kaye M Reid-Lombardo, MD, FACS, Assistant Professor of Surgery, Division of Gastroenterologic and General Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. reidlombardo.kaye@mayo.edu
Telephone: +1-507-2841529 Fax: +1-507-2845196
Received: May 18, 2010
Revised: September 16, 2010
Accepted: September 23, 2010
Published online: October 27, 2010
Abstract

Intraductal papillary mucinous neoplasm (IPMN) was first recognized in the 1980s with increasing publications over the last decade as the incidence increased sharply, especially at tertiary-care referral centers. Population-based studies have estimated the age and sex-adjusted cumulative incidence of IPMN to be 2.04 per 100 000 person-years (95% confidence interval: 1.28-2.80). It is now understood that IPMN can be classified anywhere along the spectrum of the adenoma to carcinoma sequence and often harbors mutations in genes such as KRAS early in the disease process. Many patients are diagnosed incidentally after imaging of the abdomen for other diagnostic purposes. Patients that present with a history of symptoms such as pancreatitis and abdominal pain are at high risk of harboring a malignancy. Clinicopathologic features such as involvement of the main pancreatic duct, presence of mural nodules, and side branch disease > 3.0 cm in size may indicate that there is an underlying invasive component to the IPMN. In addition, the incidence of extra-pancreatic neoplasms is higher in patients with IPMN, with reported rates of 25% to 50%. There are no current screening recommendations to detect and diagnose IPMN but once the diagnosis is made, screening for extrapancreatic neoplasms such as colon polyps and colorectal cancer should be considered. Surgical resection is the recommend treatment for patients with high-risk features while close observation can be offered to patients without worrisome signs and symptoms of carcinoma.

Keywords: Intraductal papillary mucinous neoplasm, Incidence, Prevalence, Risk factors, Screening