Fatty Pancreas Disease Linked to Elevated Risk of Pancreatic Cancer

A new retrospective cohort study highlights the clinical relevance of fatty pancreas disease (FPD) as an independent risk factor for pancreatic cancer, pancreatitis, and pancreatic cysts, regardless of obesity or hepatic fat levels.

The study included 82 adults with radiologically confirmed FPD and 164 matched controls without FPD, matched by age, sex, body mass index, and smoking status. Over an average follow-up of 4 years, patients with FPD showed significantly higher intrapancreatic fat deposition (IPFD) compared to controls (26.8% vs. 4.9%, p < 0.001).

Clinical outcomes revealed a clear pattern. Patients with FPD had higher rates of acute pancreatitis (12% vs. 1.2%), chronic pancreatitis (6.1% vs. 0.6%), pancreatic cysts (34.1% vs. 4.9%), and pancreatic cancer (1.6% vs. 0%), all with statistically significant differences.

 “These findings are independent of obesity or hepatic steatosis, suggesting a potentially causative role of FPD in the pathogenesis of exocrine pancreatic diseases,” the authors reported.

Notably, the rates of extrapancreatic cancers were similar between groups, indicating the specificity of risk within the pancreas.

The key takeaway for clinicians is the importance of recognizing FPD as more than an incidental imaging finding. The study provides evidence that increased fat deposition in the pancreas may serve as a marker—or even a contributor—to long-term pancreatic pathology. Routine reporting and longitudinal monitoring of FPD in at-risk populations may aid in earlier detection and intervention strategies for pancreatic diseases.

Reference
Chatterjee A, Singh A, Thomas RJ, et al. Fatty pancreas disease and the risk of future diseases of the exocrine pancreas: a US matched cohort study. Am J Gastroenterol. Published online August 22, 2025. doi:10.14309/ajg.0000000000003725