Mucinous cystic neoplasia (MCN) of the pancreas: systematic review and meta-analysis of sex differences in prevalence and malignancy risk between males and females.

Background: Among the pancreatic cystic neoplasia, the mucinous cystic neoplasia (MCN) is less-well understood as these are a much rarer to come by and a poorly described cyst entity. Notably, the MCNs have previously been thought to almost exclusively develop in females, with few reports of MCN in males. Here we present a case of male MCN together with a systematic review of the disparities in sex-dependent prevalence and malignancy risk as found in the literature.

Methods: A systematic review and meta-analysis were conducted on pre-existing literature to assess the incidence and malignancy rates of MCN in male and female patients. The study protocol was prospectively registered on PROSPERO (CRD42024606793). A comprehensive search of PubMed, Embase, MEDLINE and Web of Science was performed covering all studies published from January 2014 to August 2024.

Results: The study included 51 studies with a total of 3,519 patients. Prevalence rates show a marked predominance of MCN in female patients at 84.5% [95% confidence interval (CI): 80.5-87.9%], while malignancy rates are significantly higher in male patients with MCN 47.2% (95% CI: 26.1-69.3%) compared to females at 16.6% (95% CI: 6.4-36.6%).

Conclusions: Among all studies reporting on MCN, the systematic review of accumulated data found an overall prevalence of 14.2% in males, but with an almost 50% risk of malignancy rate in males compared to females.