P Bertuccio1, C La Vecchia1, D T Silverman2, G M Petersen3, P M Bracci4, E Negri5, D Li6, H A Risch7, S H Olson8, S Gallinger9, A B Miller10, H B Bueno-de-Mesquita11, R Talamini12, J Polesel12, P Ghadirian13, P A Baghurst14, W Zatonski15, E T Fontham16, W R Bamlet3, E A Holly4, E Lucenteforte1, M Hassan6, H Yu7, R C Kurtz17, M Cotterchio18, J Su2, P Maisonneuve19, E J Duell20, C Bosetti5, P Boffetta21. 1. Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Department of Occupational Health, Section of Medical Statistics, University of Milan, Milan, Italy. 2. National Cancer Institute, Bethesda. 3. Mayo Clinic, Rochester. 4. University of California, San Francisco. 5. Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. 6. The University of Texas M.D Anderson Cancer Center, Houston. 7. Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven. 8. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA. 9. Toronto General Hospital. 10. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 11. National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands. 12. Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico (CRO), Aviano, Italy. 13. Epidemiology Research Unit, Research Centre (CRCHUM), Montréal, Canada. 14. Public Health, Women's and Children's Hospital, Adelaide, Australia. 15. Cancer Center & Institute of Oncology, Warsaw, Poland. 16. Louisiana State University, School of Public Health, New Orleans. 17. Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, USA. 18. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Cancer Care Ontario, Toronto, Canada. 19. European Institute of Oncology, Milan, Italy. 20. Catalan Institute of Oncology (ICO), Barcelona, Spain. 21. International Prevention Research Institute, Lyon, France; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA. Electronic address: paolo.boffetta@mssm.edu.
Abstract
BACKGROUND: Cigarette smoking is the best-characterized risk factor for pancreatic cancer. However, data are limited for other tobacco smoking products and smokeless tobacco. MATERIALS AND METHODS: We conducted a pooled analysis of cigar and pipe smoking and smokeless tobacco use and risk of pancreatic cancer using data from 11 case-control studies (6056 cases and 11,338 controls) within the International Pancreatic Cancer Case-Control Consortium (PanC4). Pooled odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated by unconditional multiple logistic regression models adjusted for study center and selected covariates. RESULTS: Compared with never tobacco users, the OR for cigar-only smokers was 1.6 (95% CI: 1.2-2.3), i.e. comparable to that of cigarette-only smokers (OR 1.5; 95% CI 1.4-1.6). The OR was 1.1 (95% CI 0.69-1.6) for pipe-only smokers. There was some evidence of increasing risk with increasing amount of cigar smoked per day (OR 1.82 for ≥ 10 grams of tobacco), although not with duration. The OR for ever smokeless tobacco users as compared with never tobacco users was 0.98 (95% CI 0.75-1.3). CONCLUSION: This collaborative analysis provides evidence that cigar smoking is associated with an excess risk of pancreatic cancer, while no significant association emerged for pipe smoking and smokeless tobacco use.
BACKGROUND: Cigarette smoking is the best-characterized risk factor for pancreatic cancer. However, data are limited for other tobacco smoking products and smokeless tobacco. MATERIALS AND METHODS: We conducted a pooled analysis of cigar and pipe smoking and smokeless tobacco use and risk of pancreatic cancer using data from 11 case-control studies (6056 cases and 11,338 controls) within the International Pancreatic Cancer Case-Control Consortium (PanC4). Pooled odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated by unconditional multiple logistic regression models adjusted for study center and selected covariates. RESULTS: Compared with never tobacco users, the OR for cigar-only smokers was 1.6 (95% CI: 1.2-2.3), i.e. comparable to that of cigarette-only smokers (OR 1.5; 95% CI 1.4-1.6). The OR was 1.1 (95% CI 0.69-1.6) for pipe-only smokers. There was some evidence of increasing risk with increasing amount of cigar smoked per day (OR 1.82 for ≥ 10 grams of tobacco), although not with duration. The OR for ever smokeless tobacco users as compared with never tobacco users was 0.98 (95% CI 0.75-1.3). CONCLUSION: This collaborative analysis provides evidence that cigar smoking is associated with an excess risk of pancreatic cancer, while no significant association emerged for pipe smoking and smokeless tobacco use.
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