OBJECTIVES: Although cigarette smoking is the most well-established environmental risk factor for pancreatic cancer, the interaction between smoking and other risk factors has not been assessed. We evaluated the independent effects of multiple risk factors for pancreatic cancer and determined whether the magnitude of cigarette smoking was modified by other risk factors in men and women. METHODS: We conducted a hospital-based case-control study involving 808 patients with pathologically diagnosed pancreatic cancer and 808 healthy frequency-matched controls. Information on risk factors was collected by personal interview, and unconditional logistic regression was used to determine adjusted odds ratios (AORs) by the maximum-likelihood method. RESULTS: Cigarette smoking, family history of pancreatic cancer, heavy alcohol consumption (>60 mL ethanol/day), diabetes mellitus, and history of pancreatitis were significant risk factors for pancreatic cancer. We found synergistic interactions between cigarette smoking and family history of pancreatic cancer (AOR 12.8, 95% confidence interval [CI] 1.6-108.9) and diabetes mellitus (AOR 9.3, 95% CI 2.0-44.1) in women, according to an additive model. Approximately 23%, 9%, 3%, and 5% of pancreatic cancer cases in this study were related to cigarette smoking, diabetes mellitus, heavy alcohol consumption, and family history of pancreatic cancer, respectively. CONCLUSIONS: The significant synergy between these risk factors suggests a common pathway for carcinogenesis of the pancreas. Determining the underlying mechanisms for such synergies may lead to the development of pancreatic cancer prevention strategies for high-risk individuals.
OBJECTIVES: Although cigarette smoking is the most well-established environmental risk factor for pancreatic cancer, the interaction between smoking and other risk factors has not been assessed. We evaluated the independent effects of multiple risk factors for pancreatic cancer and determined whether the magnitude of cigarette smoking was modified by other risk factors in men and women. METHODS: We conducted a hospital-based case-control study involving 808 patients with pathologically diagnosed pancreatic cancer and 808 healthy frequency-matched controls. Information on risk factors was collected by personal interview, and unconditional logistic regression was used to determine adjusted odds ratios (AORs) by the maximum-likelihood method. RESULTS: Cigarette smoking, family history of pancreatic cancer, heavy alcohol consumption (>60 mL ethanol/day), diabetes mellitus, and history of pancreatitis were significant risk factors for pancreatic cancer. We found synergistic interactions between cigarette smoking and family history of pancreatic cancer (AOR 12.8, 95% confidence interval [CI] 1.6-108.9) and diabetes mellitus (AOR 9.3, 95% CI 2.0-44.1) in women, according to an additive model. Approximately 23%, 9%, 3%, and 5% of pancreatic cancer cases in this study were related to cigarette smoking, diabetes mellitus, heavy alcohol consumption, and family history of pancreatic cancer, respectively. CONCLUSIONS: The significant synergy between these risk factors suggests a common pathway for carcinogenesis of the pancreas. Determining the underlying mechanisms for such synergies may lead to the development of pancreatic cancer prevention strategies for high-risk individuals.
Authors: A B Lowenfels; P Maisonneuve; G Cavallini; R W Ammann; P G Lankisch; J R Andersen; E P Dimagno; A Andrén-Sandberg; L Domellöf Journal: N Engl J Med Date: 1993-05-20 Impact factor: 91.245
Authors: V Kalapothaki; A Tzonou; C C Hsieh; N Toupadaki; A Karakatsani; D Trichopoulos Journal: Cancer Causes Control Date: 1993-07 Impact factor: 2.506
Authors: Antonio Pea; Jun Yu; Neda Rezaee; Claudio Luchini; Jin He; Marco Dal Molin; James F Griffin; Helen Fedor; Shahriar Fesharakizadeh; Roberto Salvia; Matthew J Weiss; Claudio Bassi; John L Cameron; Lei Zheng; Aldo Scarpa; Ralph H Hruban; Anne Marie Lennon; Michael Goggins; Christopher L Wolfgang; Laura D Wood Journal: Ann Surg Date: 2017-07 Impact factor: 12.969
Authors: Elizabeth Won; Kenneth H Yu; Ali Shamseddine; Leonard Saltz; Deborah Mukherjee; Ali Haydar; Ashwaq El-Olayan; Sally Temraz; Mohamed Naghy; Dorothy Makanjoula; Eileen M O'Reilly; Ghassan K Abou-Alfa Journal: Gastrointest Cancer Res Date: 2013-03