Main Pancreatic Duct Dilation Increases Odds for Neoplastic Progression in High-Risk Individuals

WEDNESDAY, Nov. 19, 2025 (HealthDay News) — Main pancreatic duct (MPD) dilation without an apparent obstructing lesion is an independent risk factor for neoplastic progression to high-grade dysplasia or pancreatic ductal adenocarcinoma in high-risk individuals (HRI), according to a study published in the November issue of Gastro Hep Advances.

Elizabeth Abou Diwan, M.D., from Johns Hopkins School of Medicine in Baltimore, and colleagues analyzed prospectively collected data from 641 asymptomatic HRI undergoing surveillance for mild dilatation of the MPD during a median 3.6 years. The risk for neoplastic progression was evaluated.

The researchers found that 15 percent (97 individuals) had MPD dilation without evidence of an obstructing mass lesion, with 10.3 percent diagnosed with neoplastic progression within a median of two years after dilation was first detected. In HRI with baseline MPD dilation, the cumulative probability of high-grade dysplasia or pancreatic ductal adenocarcinoma was 16 percent at five years and 26 percent at 10 years. Progression was 2.6 times more likely among HRI with any MPD dilation, particularly those with three or more pancreatic cysts during surveillance (adjusted hazard ratio, 9.07).

“We are identifying pancreas duct dilatation as an early sign of pancreatic cancer in high-risk individuals even when there is no visible mass,” Marcia Irene Canto, M.D., also from Johns Hopkins, said in a statement. “This finding may lead to better survival if cancers are detected early.”

Abstract/Full Text