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Pancreatic Neoplasms: HELP
Articles by Paolo Boffetta
Based on 26 articles published since 2009
(Why 26 articles?)
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Between 2009 and 2019, P. Boffetta wrote the following 26 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review The Role of Common Pharmaceutical Agents on the Prevention and Treatment of Pancreatic Cancer. 2016

Amin, Sunil / Boffetta, Paolo / Lucas, Aimee L. ·Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Tisch Cancer Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ·Gut Liver · Pubmed #27563018.

ABSTRACT: Survival from pancreatic cancer remains poor. Conventional treatment has resulted in only marginal improvements in survival compared with survival in the previous several decades. Thus, considerable interest has emerged regarding the potential use of common pharmaceutical agents as chemopreventative and chemotherapeutic options. Aspirin, metformin, statins, β-blockers, and bisphosphonates have biologically plausible mechanisms to inhibit pancreatic neoplasia, whereas dipeptidyl-peptidase 4 inhibitors may promote it. Regardless, real-world epidemiological data remain inconclusive. This review examines the hypotheses, evidence, and current state of the literature for each of these medications and their potential roles in the prevention and treatment of pancreatic cancer.

2 Review Lack of association between occupational exposure to diesel exhaust and risk of pancreatic cancer: a systematic evaluation of available data. 2014

Boffetta, Paolo. ·Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA, paolo.boffetta@mssm.edu. ·Int Arch Occup Environ Health · Pubmed #23851578.

ABSTRACT: PURPOSE: To review epidemiologic studies on risk of pancreatic cancer and occupational exposure to diesel exhaust. METHODS: A literature search was conducted, and data were abstracted in a systematic fashion. Comparable results were combined using a random-effects meta-analysis. RESULTS: Twenty-six studies were included in the review, including five studies based on routine statistics, 11 case-control studies [meta-relative risk (RR) of three estimates for diesel exhaust exposure 0.9; 95 % confidence interval (CI) 0.5, 1.6] and ten cohort studies (meta-RR of their results: 1.03; 95 % CI 0.93, 1.13). Few studies reported results according to duration of exposure or other quantitative measures; no consistent pattern emerged. CONCLUSIONS: The overall evidence from studies on occupational exposure to diesel exhaust and risk of pancreatic cancer leads to the conclusion of the absence of such association.

3 Article Mutations in Known and Novel cancer Susceptibility Genes in Young Patients with Pancreatic Cancer. 2018

Alimirzaie, Sahar / Mohamadkhani, Ashraf / Masoudi, Sahar / Sellars, Erin / Boffetta, Paolo / Malekzadeh, Reza / Akbari, Mohammad R / Pourshams, Akram. ·Faculty of Arts & Science, University of Toronto, Toronto, Canada. · Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. · Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. · Women's College Research Institute, University of Toronto, Toronto, Canada. · Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA. · Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. ·Arch Iran Med · Pubmed #29940740.

ABSTRACT: BACKGROUND: Pancreatic cancer is the fourth most common cause of mortality due to cancer, globally. It has a poor prognosis and is usually diagnosed at later stages when tumor resection is not possible. Heritability for pancreatic cancer is relatively high and clinically significant. METHODS: A group of 24 pancreatic cancer patients with young age at onset, from a referral hospital in Tehran University of Medical Sciences were screened for mutations in 710 cancer relevant genes using next generation sequencing technology. RESULTS: Two patients had pathogenic mutations in known pancreatic cancer susceptibility genes, BRCA1/2. Two other patients also had potentially pathogenic mutations in 2 novel candidate genes including PARP4 and EXO1. CONCLUSION: BRCA1/2 genes are the most commonly mutated pancreatic cancer susceptibility genes that should be considered in all pancreatic cancer cases with young age at onset or a family history of cancer. PARP4 and EXO1 also are potential candidate genes for susceptibility to pancreatic cancer. Identifying the hereditary cases of pancreatic cancer will help to offer more targeted treatments to the patients and also to prevent cancer in family members who might be a mutation carrier.

4 Article Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study. 2018

Moossavi, Shirin / Mohamadnejad, Mehdi / Pourshams, Akram / Poustchi, Hossein / Islami, Farhad / Sharafkhah, Maryam / Mirminachi, Babak / Nasseri-Moghaddam, Siavosh / Semnani, Shahryar / Shakeri, Ramin / Etemadi, Arash / Merat, Shahin / Khoshnia, Masoud / Dawsey, Sanford M / Pharoah, Paul D / Brennan, Paul / Abnet, Christian C / Boffetta, Paolo / Kamangar, Farin / Malekzadeh, Reza. ·Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. · Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia. · Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran. · Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland. · Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. · International Agency for Research on Cancer, Lyon, France. · The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, New York. · School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland. · Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. malek@tums.ac.ir. ·Cancer Epidemiol Biomarkers Prev · Pubmed #29263189.

ABSTRACT:

5 Article Dietary acrylamide and the risk of pancreatic cancer in the International Pancreatic Cancer Case-Control Consortium (PanC4). 2017

Pelucchi, C / Rosato, V / Bracci, P M / Li, D / Neale, R E / Lucenteforte, E / Serraino, D / Anderson, K E / Fontham, E / Holly, E A / Hassan, M M / Polesel, J / Bosetti, C / Strayer, L / Su, J / Boffetta, P / Duell, E J / La Vecchia, C. ·Department of Clinical Sciences and Community Health, University of Milan, Milan. · Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. · Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco. · Department of Gastrointestinal Medical Oncology, M.D. Anderson Cancer Center, University of Texas, Houston, USA. · Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia. · Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence. · Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano (PN), Italy. · School of Public Health, University of Minnesota, Minneapolis. · Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, USA. · Department of Epidemiology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock. · The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA. · Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. ·Ann Oncol · Pubmed #27836886.

ABSTRACT: Background: Occupational exposure to acrylamide was associated with excess mortality from pancreatic cancer, though in the absence of dose-risk relationship. Few epidemiological studies have examined the association between acrylamide from diet and pancreatic cancer risk. Patients and methods: We considered this issue in a combined set of 1975 cases of pancreatic cancer and 4239 controls enrolled in six studies of the Pancreatic Cancer Case-Control Consortium (PanC4). We calculated pooled odds ratios (ORs) and their 95% confidence intervals (CI) by estimating study-specific ORs through multivariate unconditional logistic regression models and pooling the obtained estimates using random-effects models. Results: Compared with the lowest level of estimated dietary acrylamide intake, the pooled ORs were 0.97 (95% CI, 0.79-1.19) for the second, 0.91 (95% CI, 0.71-1.16) for the third, and 0.92 (95% CI, 0.66-1.28) for the fourth (highest) quartile of intake. For an increase of 10 µg/day of acrylamide intake, the pooled OR was 0.96 (95% CI, 0.87-1.06), with heterogeneity between estimates (I2 = 67%). Results were similar across various subgroups, and were confirmed when using a one-stage modelling approach. Conclusions: This PanC4 pooled-analysis found no association between dietary acrylamide and pancreatic cancer.

6 Article Metformin Improves Survival in Patients with Pancreatic Ductal Adenocarcinoma and Pre-Existing Diabetes: A Propensity Score Analysis. 2016

Amin, S / Mhango, G / Lin, J / Aronson, A / Wisnivesky, J / Boffetta, P / Lucas, Aimee L. ·Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. ·Am J Gastroenterol · Pubmed #27430290.

ABSTRACT: OBJECTIVES: Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal disease. Diabetes mellitus (DM) is both a risk factor for and a sequela of PDAC. Metformin is a commonly prescribed biguanide oral hypoglycemic used for the treatment of type II DM. We investigated whether metformin use before PDAC diagnosis affected survival of patients with DM, controlling confounders such as diabetic severity. METHODS: We used the Surveillance, Epidemiology, and End Results registry (SEER)-Medicare linked database to identify patients with PDAC diagnosed between 2007 and 2011. The diabetic TO comorbidity severity index (DCSI) controlled for DM severity. Inverse propensity weighted Cox Proportional-Hazard Models assessed the association between metformin use and overall survival adjusting for relevant confounders. RESULTS: We identified 1,916 patients with PDAC and pre-existing DM on hypoglycemic medications at least 1 year before cancer diagnosis. Of these, 1,098 (57.3%) were treated with metformin and 818 (42.7%) with other DM medications. Mean survival for those on metformin was 5.5 months compared with 4.2 months for those not on metformin (P<0.01). After adjusting for confounders including DCSI, Charlson score, and chronic kidney disease (CKD), patients on metformin had a 12% decreased risk of mortality compared with patients on other medications (hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.81-0.96, P<0.01). In stratified analysis, differences persisted regardless of the Charlson score, the DCSI score, the presence of kidney disease, or the use of insulin/other hypoglycemic medications (P<0.01 for all). CONCLUSIONS: Metformin is associated with increased survival among diabetics with PDAC. If confirmed in a prospective study, then these results suggest a possible role for metformin as an adjunct to chemotherapy among diabetics with PDAC.

7 Article Opium use, cigarette smoking, and alcohol consumption in relation to pancreatic cancer. 2016

Shakeri, Ramin / Kamangar, Farin / Mohamadnejad, Mehdi / Tabrizi, Reza / Zamani, Farhad / Mohamadkhani, Ashraf / Nikfam, Sepideh / Nikmanesh, Arash / Sotoudeh, Masoud / Sotoudehmanesh, Rasoul / Shahbazkhani, Bijan / Ostovaneh, Mohammad Reza / Islami, Farhad / Poustchi, Hossein / Boffetta, Paolo / Malekzadeh, Reza / Pourshams, Akram. ·aDigestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran bDigestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran cDepartment of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD dLiver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences eGastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences fSasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran, Iran gDivision of Gastroenterology and Hepatology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD hAmerican Cancer Society, Atlanta, GA iInstitute for Transitional Epidemiology and the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY. ·Medicine (Baltimore) · Pubmed #27428185.

ABSTRACT: BACKGROUND AND AIMS: Although several studies have suggested opium as a risk factor for cancers of the esophagus, stomach, larynx, lung, and bladder, no previous study has examined the association of opium with pancreatic cancer. We aimed to study the association between opium use and risk of pancreatic cancer in Iran, using a case-control design. We also studied the association of cigarette smoking and alcohol consumption with pancreatic cancer, for which little information was available from this population. METHODS: Cases and controls were selected from patients who were referred to 4 endoscopic ultrasound centers in Tehran, Iran. We recruited 316 histopathologically (all adenocarcinoma) and 41 clinically diagnosed incident cases of pancreatic cancer, as well as 328 controls from those with a normal pancreas in enodosonography from January 2011 to January 2015. We used logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: After adjustment for potential confounders, opium use (OR 1.91; 95% CI 1.06-3.43) and alcohol consumption (OR 4.16; 95% CI 1.86-9.31) were significantly associated with an increased risk of pancreatic cancer. We did not find an association between ever tobacco smoking and pancreatic cancer risk (OR 0.93; 95% CI 0.62-1.39). CONCLUSION: In our study, opium use and alcohol consumption were associated with an increased risk of pancreatic cancer, whereas cigarette smoking was not.

8 Article Global Trends in Pancreatic Cancer Mortality From 1980 Through 2013 and Predictions for 2017. 2016

Lucas, Aimee L / Malvezzi, Matteo / Carioli, Greta / Negri, Eva / La Vecchia, Carlo / Boffetta, Paolo / Bosetti, Cristina. ·Henry D. Janowitz Division of Gastroenterology, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: aimee.lucas@mssm.edu. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York. ·Clin Gastroenterol Hepatol · Pubmed #27266982.

ABSTRACT: BACKGROUND & AIMS: Pancreatic cancer is a leading cause of cancer mortality, and its mortality has not decreased in recent years. We sought to determine global trends in pancreatic cancer mortality. METHODS: We derived data on deaths from pancreatic cancer from the World Health Organization database for 59 countries from 1980 through 2013. Age-standardized mortalities were computed for persons of all ages and for persons 35-64 years old; for selected countries, they were computed for persons 25-49 years old. Joinpoint regression models were used to identify significant changes in mortality. For selected larger countries, we predicted number of deaths and mortality for 2017. RESULTS: Between 1980 and 2013, overall pancreatic cancer mortality in men increased in the European Union (EU) as well as in Southern and Eastern Europe, Brazil, Japan, and Republic of Korea. Overall pancreatic cancer mortality decreased in most Northern European countries, Australia, Canada, Mexico, and the United States (US). In women, mortality increased in the EU, Brazil, US, Japan, and Republic of Korea but decreased in Canada and Mexico. In 2012, Eastern Europe and Japan had the highest pancreatic cancer mortality for both sexes. In men 25-49 years old, mortality decreased in the EU, US, Japan, and most large European countries. On the basis of our data, we predict overall pancreatic cancer mortality in 2017 to level off in men in the EU and US but increase in Japan. In women, mortality will continue to increase in most countries except the US; the greatest increase is predicted to occur in Japan. CONCLUSIONS: Mortality from pancreatic cancer has not decreased as it has for other cancers in recent years. A notable exception is a decrease in mortality in men 25-49 years old, which could indicate a reversal in the current increasing global trends.

9 Article Dietary total antioxidant capacity and pancreatic cancer risk: an Italian case-control study. 2016

Lucas, Aimee L / Bosetti, Cristina / Boffetta, Paolo / Negri, Eva / Tavani, Alessandra / Serafini, Mauro / Polesel, Jerry / Serraino, Diego / La Vecchia, Carlo / Rossi, Marta. ·Samuel Bronfman Department of Medicine, Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York 10029, USA. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan 20156, Italy. · Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York 10029, USA. · Functional Foods and Metabolic Stress Prevention Laboratory, Center for Food and Nutrition, Research Center on Agriculture and Economics, Rome 00178, Italy. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano (PN) 33081, Italy. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan 20133, Italy. ·Br J Cancer · Pubmed #27172251.

ABSTRACT: BACKGROUND: Pancreatic cancer is one of the leading causes of cancer mortality. Diet may be associated with pancreatic cancer, but it is unknown whether specific dietary components contribute to its risk. The potential differential role of dietary antioxidants warrants further investigation. METHODS: We analysed data from a case-control study of 326 pancreatic cancer cases and 652 controls conducted between 1991 and 2008 in Northern Italy. Subjects' usual diet was assessed through a validated and reproducible food frequency questionnaire. Using this information and an Italian food composition database, we calculated three indices of dietary total antioxidant capacity (TAC): Trolox equivalent antioxidant capacity (TEAC), total radical-trapping antioxidant parameter (TRAP) and ferric-reducing antioxidant power (FRAP). We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for pancreatic cancer using multiple logistic regression models conditioned on study centre, sex and age, and adjusted for major known pancreatic cancer risk factors. RESULTS: Significant inverse associations were found for the highest tertile of TAC compared with the lowest tertile for both TEAC and FRAP. The ORs were 0.61 (95% CI 0.39-0.94, P-value for trend 0.03) and 0.63 (95% CI 0.41-0.99, P-value for trend 0.05), respectively. Total radical-trapping antioxidant parameter was inversely, but not significantly, associated with pancreatic cancer risk, with an OR of 0.78 (95% CI 0.49-1.24, P-value for trend 0.27). CONCLUSIONS: Diet high in TAC, as measured by TEAC and FRAP, is inversely associated with pancreatic cancer risk.

10 Article Adherence to World Cancer Research Fund/American Institute for Cancer Research recommendations and pancreatic cancer risk. 2016

Lucas, Aimee L / Bravi, Francesca / Boffetta, Paolo / Polesel, Jerry / Serraino, Diego / La Vecchia, Carlo / Bosetti, Cristina. ·Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, NY, USA. Electronic address: aimee.lucas@mssm.edu. · Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri"-IRCCS, Milan, Italy. · Tisch Cancer Institute and Institute of Translational Epidemiology, Icahn School of Medicine at Mount Sinai, NY, USA. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano (PN), Italy. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. ·Cancer Epidemiol · Pubmed #26605429.

ABSTRACT: BACKGROUND: Pancreatic cancer is a leading cause of cancer death. A role of dietary factors in pancreatic carcinogenesis has been suggested. The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) published 8 recommendations for cancer prevention. We evaluated the effect of adherence to the WCRF/AICR recommendations on pancreatic cancer risk. METHODS: We operationalized 7 of the 8 WCRF/AICR recommendations to generate a WCRF/AICR score. We examined the association of WCRF/AICR score with pancreatic cancer in data from an Italian case-control study of 326 incident cases and 652 controls. RESULTS: Adherence to WCRF/AICR recommendations was associated with a significantly decreased risk of pancreatic cancer. Using a WCRF/AICR score <3.5 as a reference, the adjusted odds ratio (OR) for a score 3.5-<4 was 0.80 (95% CI 0.49, 1.28), for a score 4-<5 0.54 (95% CI 0.35, 0.82), and for score 5 or more 0.41 (95% CI 0.24, 0.68; p-value for trend 0.0002). The OR for a continuous increment of one unit of the WCRF/AICR score was 0.72 (95% CI 0.60, 0.87). CONCLUSION: Adherence to the WCRF/AICR recommendations may reduce pancreatic cancer risk.

11 Article Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. 2014

Bosetti, C / Rosato, V / Li, D / Silverman, D / Petersen, G M / Bracci, P M / Neale, R E / Muscat, J / Anderson, K / Gallinger, S / Olson, S H / Miller, A B / Bas Bueno-de-Mesquita, H / Scelo, G / Janout, V / Holcatova, I / Lagiou, P / Serraino, D / Lucenteforte, E / Fabianova, E / Ghadirian, P / Baghurst, P A / Zatonski, W / Foretova, L / Fontham, E / Bamlet, W R / Holly, E A / Negri, E / Hassan, M / Prizment, A / Cotterchio, M / Cleary, S / Kurtz, R C / Maisonneuve, P / Trichopoulos, D / Polesel, J / Duell, E J / Boffetta, P / La Vecchia, C. ·Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy cristina.bosetti@marionegri.it. · Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy. · M.D. Anderson Cancer Center, University of Texas, Houston. · Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda. · Department of Health Sciences Research, Medicine and Medical Genetics, Mayo Clinic, Rochester. · Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA. · Queensland Institute of Medical Research, Brisbane, Australia. · Department of Public Health Sciences, Penn State University, Penn State. · Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA. · University Health Network, Department of Surgery, University of Toronto, Toronto, Canada. · Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA. · Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. · National Institute for Public Health and the Environment (RIVM), Bilthoven Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. · International Agency for Research on Cancer (IARC), Lyon, France. · Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc. · Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. · Department of Epidemiology, Harvard School of Public Health, Boston, USA Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece. · Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, IRCCS, Aviano. · Department of Preclinical and Clinical Pharmacology Mario Aiazzi Mancini, Università degli Studi di Firenze, Florence, Italy. · Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia. · Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy M.D. Anderson Cancer Center, University of Texas, Houston Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda Department of Health Sciences Research, Medicine and Medical Genetics, Mayo Clinic, Rochester Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA Queensland Institute of Medical Research, Brisbane, Australia Department of Public Health Sciences, Penn State University, Penn State Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA University Health Network, Department of Surgery, University of Toronto, Toronto, Canada Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA Dalla Lana School of Public Health, University of Toronto, Toronto, Canada National Institute for Public Health and the Environment (RIVM), Bilthoven Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK International Agency for Research on Cancer (IARC), Lyon, France Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic Department of Epidemiology, Harvard School of Public Health, Boston, USA Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, IRCCS, Aviano Department of Preclinical and Clinical Pharmacology Mario Aiazzi Mancini, Università degli Studi di Firenze, Florence, Italy Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia Public Health, Women · Public Health, Women's and Children's Hospital, Adelaide, SA, Australia. · Cancer Center and Institute of Oncology, Warsaw, Poland. · Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Institute and MF MU, Brno, Czech Republic. · Louisiana State University School of Public Health, New Orleans, USA. · Dalla Lana School of Public Health, University of Toronto, Toronto, Canada Cancer Care Ontario, Toronto, Canada. · Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA. · Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · Department of Epidemiology, Harvard School of Public Health, Boston, USA. · Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. · The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA. · Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. ·Ann Oncol · Pubmed #25057164.

ABSTRACT: BACKGROUND: Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications. PATIENTS AND METHODS: We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates. RESULTS: Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for <5 years), but not for longer duration of use (OR 0.95, 95% CI 0.53-1.70, for ≥15 years). CONCLUSION: This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.

12 Article Ulcer, gastric surgery and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium (PanC4). 2013

Bosetti, C / Lucenteforte, E / Bracci, P M / Negri, E / Neale, R E / Risch, H A / Olson, S H / Gallinger, S / Miller, A B / Bueno-de-Mesquita, H B / Talamini, R / Polesel, J / Ghadirian, P / Baghurst, P A / Zatonski, W / Fontham, E / Holly, E A / Gao, Y T / Yu, H / Kurtz, R C / Cotterchio, M / Maisonneuve, P / Zeegers, M P / Duell, E J / Boffetta, P / La Vecchia, C. ·Department of Epidemiology, IRCCS, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan. ·Ann Oncol · Pubmed #23970016.

ABSTRACT: BACKGROUND: Peptic ulcer and its treatments have been associated to pancreatic cancer risk, although the evidence is inconsistent. METHODS: We pooled 10 case-control studies within the Pancreatic Cancer Case-control Consortium (PanC4), including 4717 pancreatic cancer cases and 9374 controls, and estimated summary odds ratios (OR) using multivariable logistic regression models. RESULTS: The OR for pancreatic cancer was 1.10 [95% confidence interval (CI) 0.98-1.23] for history of ulcer (OR = 1.08 for gastric and 0.97 for duodenal ulcer). The association was stronger for a diagnosis within 2 years before cancer diagnosis (OR = 2.43 for peptic, 1.75 for gastric, and 1.98 for duodenal ulcer). The OR was 1.53 (95% CI 1.15-2.03) for history of gastrectomy; however, the excess risk was limited to a gastrectomy within 2 years before cancer diagnosis (OR = 6.18, 95% CI 1.82-20.96), while no significant increased risk was observed for longer time since gastrectomy. No associations were observed for pharmacological treatments for ulcer, such as antacids, H2-receptor antagonists, or proton-pump inhibitors. CONCLUSIONS: This uniquely large collaborative study does not support the hypothesis that peptic ulcer and its treatment materially affect pancreatic cancer risk. The increased risk for short-term history of ulcer and gastrectomy suggests that any such association is due to increased cancer surveillance.

13 Article Association of body mass index and risk of death from pancreas cancer in Asians: findings from the Asia Cohort Consortium. 2013

Lin, Yingsong / Fu, Rong / Grant, Eric / Chen, Yu / Lee, Jung Eun / Gupta, Prakash C / Ramadas, Kunnambath / Inoue, Manami / Tsugane, Shoichiro / Gao, Yu-Tang / Tamakoshi, Akiko / Shu, Xiao-Ou / Ozasa, Kotaro / Tsuji, Ichiro / Kakizaki, Masako / Tanaka, Hideo / Chen, Chien-Jen / Yoo, Keun-Young / Ahn, Yoon-Ok / Ahsan, Habibul / Pednekar, Mangesh S / Sauvaget, Catherine / Sasazuki, Shizuka / Yang, Gong / Xiang, Yong-Bing / Ohishi, Waka / Watanabe, Takashi / Nishino, Yoshikazu / Matsuo, Keitaro / You, San-Lin / Park, Sue K / Kim, Dong-Hyun / Parvez, Faruque / Rolland, Betsy / McLerran, Dale / Sinha, Rashmi / Boffetta, Paolo / Zheng, Wei / Thornquist, Mark / Feng, Ziding / Kang, Daehee / Potter, John D. ·Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan. linys@aichi-med-u.ac.jp ·Eur J Cancer Prev · Pubmed #23044748.

ABSTRACT: We aimed to examine the association between BMI and the risk of death from pancreas cancer in a pooled analysis of data from the Asia Cohort Consortium. The data for this pooled analysis included 883 529 men and women from 16 cohort studies in Asian countries. Cox proportional-hazards models were used to estimate the hazard ratios and 95% confidence intervals for pancreas cancer mortality in relation to BMI. Seven predefined BMI categories (<18.5, 18.5-19.9, 20.0-22.4, 22.5-24.9, 25.0-27.4, 27.5-29.9, ≥ 30) were used in the analysis, with BMI of 22.5-24.9 serving as the reference group. The multivariable analyses were adjusted for known risk factors, including age, smoking, and a history of diabetes. We found no statistically significant overall association between each BMI category and the risk of death from pancreas cancer in all Asians, and obesity was unrelated to the risk of mortality in both East Asians and South Asians. Age, smoking, and a history of diabetes did not modify the association between BMI and the risk of death from pancreas cancer. In planned subgroup analyses among East Asians, an increased risk of death from pancreas cancer among those with a BMI less than 18.5 was observed for individuals with a history of diabetes; hazard ratio=2.01 (95% confidence interval: 1.01-4.00) (P for interaction=0.07). The data do not support an association between BMI and the risk of death from pancreas cancer in these Asian populations.

14 Article Pancreatitis and pancreatic cancer risk: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). 2012

Duell, E J / Lucenteforte, E / Olson, S H / Bracci, P M / Li, D / Risch, H A / Silverman, D T / Ji, B T / Gallinger, S / Holly, E A / Fontham, E H / Maisonneuve, P / Bueno-de-Mesquita, H B / Ghadirian, P / Kurtz, R C / Ludwig, E / Yu, H / Lowenfels, A B / Seminara, D / Petersen, G M / La Vecchia, C / Boffetta, P. ·Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. eduell@iconcologia.net ·Ann Oncol · Pubmed #22767586.

ABSTRACT: BACKGROUND: Pancreatitis is a known risk factor for pancreatic cancer; however, an unknown fraction of the disease is thought to be a consequence of tumor-related duct obstruction. PATIENTS AND METHODS: A pooled analysis of a history of pancreatitis and risk of pancreatic cancer was carried out considering the time interval between diagnoses and potential modification by covariates. Adjusted pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from 10 case-control studies (5048 cases of ductal pancreatic adenocarcinoma and 10,947 controls) taking part in the International Pancreatic Cancer Case-Control Consortium (PanC4). RESULTS: The association between pancreatitis and pancreatic cancer was nearly three-fold at intervals of >2 years between diagnoses (OR: 2.71, 95% CI: 1.96-3.74) and much stronger at intervals of ≤2 years (OR: 13.56, 95% CI: 8.72-21.90) probably reflecting a combination of reverse causation and antecedent misdiagnosis of pancreas cancer as pancreatitis. The younger (<65 years) pancreatic cancer cases showed stronger associations with previous (>2 years) pancreatitis (OR: 3.91, 95% CI: 2.53-6.04) than the older (≥65 years) cases (OR: 1.68, 95% CI: 1.02-2.76; P value for interaction: 0.006). CONCLUSIONS: Despite a moderately strong association between pancreatitis (diagnosed before >2 years) and pancreatic cancer, the population attributable fraction was estimated at 1.34% (95% CI: 0.612-2.07%), suggesting that a relatively small proportion of pancreatic cancer might be avoided if pancreatitis could be prevented.

15 Article Pancreatic cancer: overview of descriptive epidemiology. 2012

Bosetti, Cristina / Bertuccio, Paola / Negri, Eva / La Vecchia, Carlo / Zeegers, Maurice P / Boffetta, Paolo. ·Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. ·Mol Carcinog · Pubmed #22162227.

ABSTRACT: Pancreatic cancer mortality rates have been increasing in high-income countries between the 1950s and the 1980s, and have leveled off or declined thereafter, particularly in men. To provide a global overview of recent pancreatic cancer mortality, we analyzed official death of the world certification data derived from the World Health Organization for 35 European countries and 19 other countries over the period 1980-2007. In 2007, the highest mortality rates from pancreatic cancer were in the Baltic countries, and some central/eastern and northern European countries (over 9.5/100 000 men and 6/100 000 women), whereas the lowest ones were in Latin America and Hong Kong (below 5/100 000 men and 3/100 000 women). Japan, the USA, Russia and the European Union (EU), as well as the largest countries in the EU, had rates around 7-9/100 000 men and 5-6/100 000 women. In the early 2000s, rates have been approximately stable in many European countries, as in the USA, Japan, and Australia. In Nordic countries and the UK, where declines in rates have been observed between the 1980s and the 1990s, mortality from pancreatic cancer has tended to rise over most recent calendar years. Some persisting rises were still found in men from a few countries of southern and central/eastern Europe (with low rates in the past), as well as in the EU overall, and in women from European and Asian countries. Recent trends were generally more favorable in young adults (30-49 yr), suggesting that overall trends are likely to improve in the near future.

16 Article Cigarette smoking and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (Panc4). 2012

Bosetti, C / Lucenteforte, E / Silverman, D T / Petersen, G / Bracci, P M / Ji, B T / Negri, E / Li, D / Risch, H A / Olson, S H / Gallinger, S / Miller, A B / Bueno-de-Mesquita, H B / Talamini, R / Polesel, J / Ghadirian, P / Baghurst, P A / Zatonski, W / Fontham, E / Bamlet, W R / Holly, E A / Bertuccio, P / Gao, Y T / Hassan, M / Yu, H / Kurtz, R C / Cotterchio, M / Su, J / Maisonneuve, P / Duell, E J / Boffetta, P / La Vecchia, C. ·Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. cristina.bosetti@marionegri.it ·Ann Oncol · Pubmed #22104574.

ABSTRACT: BACKGROUND: To evaluate the dose-response relationship between cigarette smoking and pancreatic cancer and to examine the effects of temporal variables. METHODS: We analyzed data from 12 case-control studies within the International Pancreatic Cancer Case-Control Consortium (PanC4), including 6507 pancreatic cases and 12 890 controls. We estimated summary odds ratios (ORs) by pooling study-specific ORs using random-effects models. RESULTS: Compared with never smokers, the OR was 1.2 (95% confidence interval [CI] 1.0-1.3) for former smokers and 2.2 (95% CI 1.7-2.8) for current cigarette smokers, with a significant increasing trend in risk with increasing number of cigarettes among current smokers (OR=3.4 for ≥35 cigarettes per day, P for trend<0.0001). Risk increased in relation to duration of cigarette smoking up to 40 years of smoking (OR=2.4). No trend in risk was observed for age at starting cigarette smoking, whereas risk decreased with increasing time since cigarette cessation, the OR being 0.98 after 20 years. CONCLUSIONS: This uniquely large pooled analysis confirms that current cigarette smoking is associated with a twofold increased risk of pancreatic cancer and that the risk increases with the number of cigarettes smoked and duration of smoking. Risk of pancreatic cancer reaches the level of never smokers ∼20 years after quitting.

17 Article Alcohol consumption and pancreatic cancer: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). 2012

Lucenteforte, E / La Vecchia, C / Silverman, D / Petersen, G M / Bracci, P M / Ji, B T / Bosetti, C / Li, D / Gallinger, S / Miller, A B / Bueno-de-Mesquita, H B / Talamini, R / Polesel, J / Ghadirian, P / Baghurst, P A / Zatonski, W / Fontham, E / Bamlet, W R / Holly, E A / Gao, Y T / Negri, E / Hassan, M / Cotterchio, M / Su, J / Maisonneuve, P / Boffetta, P / Duell, E J. ·Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri Milan, Milan, Italy. ·Ann Oncol · Pubmed #21536662.

ABSTRACT: BACKGROUND: Heavy alcohol drinking has been related to pancreatic cancer, but the issue is still unsolved. METHODS: To evaluate the role of alcohol consumption in relation to pancreatic cancer, we conducted a pooled analysis of 10 case-control studies (5585 cases and 11,827 controls) participating in the International Pancreatic Cancer Case-Control Consortium. We computed pooled odds ratios (ORs) by estimating study-specific ORs adjusted for selected covariates and pooling them using random effects models. RESULTS: Compared with abstainers and occasional drinkers (< 1 drink per day), we observed no association for light-to-moderate alcohol consumption (≤ 4 drinks per day) and pancreatic cancer risk; however, associations were above unity for higher consumption levels (OR = 1.6, 95% confidence interval 1.2-2.2 for subjects drinking ≥ 9 drinks per day). Results did not change substantially when we evaluated associations by tobacco smoking status, or when we excluded participants who reported a history of pancreatitis, or participants whose data were based upon proxy responses. Further, no notable differences in pooled risk estimates emerged across strata of sex, age, race, study type, and study area. CONCLUSION: This collaborative-pooled analysis provides additional evidence for a positive association between heavy alcohol consumption and the risk of pancreatic cancer.

18 Article Cigar and pipe smoking, smokeless tobacco use and pancreatic cancer: an analysis from the International Pancreatic Cancer Case-Control Consortium (PanC4). 2011

Bertuccio, P / La Vecchia, C / Silverman, D T / Petersen, G M / Bracci, P M / Negri, E / Li, D / Risch, H A / Olson, S H / Gallinger, S / Miller, A B / Bueno-de-Mesquita, H B / Talamini, R / Polesel, J / Ghadirian, P / Baghurst, P A / Zatonski, W / Fontham, E T / Bamlet, W R / Holly, E A / Lucenteforte, E / Hassan, M / Yu, H / Kurtz, R C / Cotterchio, M / Su, J / Maisonneuve, P / Duell, E J / Bosetti, C / Boffetta, P. ·Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. ·Ann Oncol · Pubmed #21245160.

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.

19 Article Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan). 2010

Michaud, Dominique S / Vrieling, Alina / Jiao, Li / Mendelsohn, Julie B / Steplowski, Emily / Lynch, Shannon M / Wactawski-Wende, Jean / Arslan, Alan A / Bas Bueno-de-Mesquita, H / Fuchs, Charles S / Gross, Myron / Helzlsouer, Kathy / Jacobs, Eric J / Lacroix, Andrea / Petersen, Gloria / Zheng, Wei / Allen, Naomi / Ammundadottir, Laufey / Bergmann, Manuela M / Boffetta, Paolo / Buring, Julie E / Canzian, Federico / Chanock, Stephen J / Clavel-Chapelon, Françoise / Clipp, Sandra / Freiberg, Matthew S / Michael Gaziano, J / Giovannucci, Edward L / Hankinson, Susan / Hartge, Patricia / Hoover, Robert N / Allan Hubbell, F / Hunter, David J / Hutchinson, Amy / Jacobs, Kevin / Kooperberg, Charles / Kraft, Peter / Manjer, Jonas / Navarro, Carmen / Peeters, Petra H M / Shu, Xiao-Ou / Stevens, Victoria / Thomas, Gilles / Tjønneland, Anne / Tobias, Geoffrey S / Trichopoulos, Dimitrios / Tumino, Rosario / Vineis, Paolo / Virtamo, Jarmo / Wallace, Robert / Wolpin, Brian M / Yu, Kai / Zeleniuch-Jacquotte, Anne / Stolzenberg-Solomon, Rachael Z. ·Division of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK. d.michaud@imperial.ac.uk ·Cancer Causes Control · Pubmed #20373013.

ABSTRACT: The literature has consistently reported no association between low to moderate alcohol consumption and pancreatic cancer; however, a few studies have shown that high levels of intake may increase risk. Most single studies have limited power to detect associations even in the highest alcohol intake categories or to examine associations by alcohol type. We analyzed these associations using 1,530 pancreatic cancer cases and 1,530 controls from the Pancreatic Cancer Cohort Consortium (PanScan) nested case-control study. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using unconditional logistic regression, adjusting for potential confounders. We observed no significant overall association between total alcohol (ethanol) intake and pancreatic cancer risk (OR = 1.38, 95% CI = 0.86-2.23, for 60 or more g/day vs. >0 to <5 g/day). A statistically significant increase in risk was observed among men consuming 45 or more grams of alcohol from liquor per day (OR = 2.23, 95% CI = 1.02-4.87, compared to 0 g/day of alcohol from liquor, P-trend = 0.12), but not among women (OR = 1.35, 95% CI = 0.63-2.87, for 30 or more g/day of alcohol from liquor, compared to none). No associations were noted for wine or beer intake. Overall, no significant increase in risk was observed, but a small effect among heavy drinkers cannot be ruled out.

20 Article Past medical history and pancreatic cancer risk: Results from a multicenter case-control study. 2010

Maisonneuve, Patrick / Lowenfels, Albert B / Bueno-de-Mesquita, H Bas / Ghadirian, Parviz / Baghurst, Peter A / Zatonski, Witold A / Miller, Anthony B / Duell, Eric J / Boffetta, Paolo / Boyle, Peter. ·European Institute of Oncology, Milan, Italy. ·Ann Epidemiol · Pubmed #20123159.

ABSTRACT: PURPOSE: To investigate risk factors that may be linked to pancreatic cancer. METHODS: We designed a multicenter population-based case-control (823 cases, 1679 control patients) study with data collection by using a common protocol and questionnaire. Participating centers were located in Australia, Canada, the Netherlands, and Poland. RESULTS: After adjustment for confounding factors, a positive history of pancreatitis was associated with pancreatic cancer (odds ratio [OR], 4.68; 95% confidence interval [95% CI], 2.23-9.84). The risk was especially high in heavy smokers (OR, 15.4; 95% CI, 3.18-74.9). Patients with diabetes had an increased risk of developing pancreatic cancer (OR, 2.16; 95% CI, 1.60-2.91). The risk was highest in the first year after the development of diabetes (OR, 6.68; 95% CI, 3.56-12.6) and decreased over time. A history of allergy was associated with a reduced risk of pancreas cancer (OR, 0.64; 95% CI, 0.50-0.82). CONCLUSIONS: Patients with newly diagnosed diabetes and patients with pancreatitis, particularly in heavy smokers, have an increased risk for developing pancreatic cancer. In addition to being risk factors, these conditions could be early manifestations of underlying pancreatic cancer. A history of allergy decreases the risk of pancreatic cancer.

21 Article Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation. 2010

Tramacere, Irene / Scotti, Lorenza / Jenab, Mazda / Bagnardi, Vincenzo / Bellocco, Rino / Rota, Matteo / Corrao, Giovanni / Bravi, Francesca / Boffetta, Paolo / La Vecchia, Carlo. ·Istituto di Ricerche Farmacologiche Mario Negri, 20156, Milano, Italy. irene.tramacere@marionegri.it ·Int J Cancer · Pubmed #19816941.

ABSTRACT: In order to provide a more precise quantification of the association between alcohol consumption and pancreatic cancer risk, we performed a meta-analysis of relevant dose-risk results. We conducted a PubMed search of all case-control (N=21) and cohort (N=11) studies published up to March 2009. We computed summary relative risk (RR) estimates using either fixed- or, in the presence of heterogeneity, random-effects models. The pooled RR was 0.92 (95% confidence interval, 95% CI, 0.86-0.97) for <3 drinks/day and 1.22 (95% CI, 1.12-1.34) for > or = 3 drinks/day. The increased risk for heavy drinking was similar in women and men, but apparently stronger in cohort studies (RR=1.29), in studies with high quality index (RR=1.30), and did not appear to be explained by residual confounding by either history of pancreatitis or tobacco smoking. This meta-analysis provides strong evidence for the absence of a role of moderate drinking in pancreatic carcinogenesis, coupled to an increased risk for heavy alcohol drinking. Given the moderate increase in risk and the low prevalence of heavy drinkers in most populations, alcohol appears to be responsible only for a small fraction of all pancreatic cancers.

22 Article Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. 2010

Vrieling, Alina / Bueno-de-Mesquita, H Bas / Boshuizen, Hendriek C / Michaud, Dominique S / Severinsen, Marianne T / Overvad, Kim / Olsen, Anja / Tjønneland, Anne / Clavel-Chapelon, Françoise / Boutron-Ruault, Marie-Christine / Kaaks, Rudolf / Rohrmann, Sabine / Boeing, Heiner / Nöthlings, Ute / Trichopoulou, Antonia / Moutsiou, Eftihia / Dilis, Vardis / Palli, Domenico / Krogh, Vittorio / Panico, Salvatore / Tumino, Rosario / Vineis, Paolo / van Gils, Carla H / Peeters, Petra H M / Lund, Eiliv / Gram, Inger T / Rodríguez, Laudina / Agudo, Antonio / Larrañaga, Nerea / Sánchez, María-José / Navarro, Carmen / Barricarte, Aurelio / Manjer, Jonas / Lindkvist, Björn / Sund, Malin / Ye, Weimin / Bingham, Sheila / Khaw, Kay-Tee / Roddam, Andrew / Key, Tim / Boffetta, Paolo / Duell, Eric J / Jenab, Mazda / Gallo, Valentina / Riboli, Elio. ·National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. ·Int J Cancer · Pubmed #19790196.

ABSTRACT: Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce. We examined the association of cigarette smoking and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% CI = 1.36-2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% CI = 1.23-2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% CI = 0.96-7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% CI = 1.00-2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.

23 Article Menstrual and reproductive factors and pancreatic cancer in the SEARCH program of the IARC. 2009

Duell, Eric J / Maisonneuve, Patrick / Baghurst, Peter A / Bueno-de-Mesquita, H Bas / Ghadirian, Parviz / Miller, Anthony B / Zatonski, Witold / Vrieling, Alina / Boffetta, Paolo / Boyle, Peter. ·Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Institut Català d'Oncologia (ICO), Catalan Institute of Oncology, Avda Gran Via 199-203, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. eduell@iconcologia.net ·Cancer Causes Control · Pubmed #19653108.

ABSTRACT: We conducted a population-based case-control study on the relation of menstrual and reproductive factors and hormone use with pancreatic cancer risk among female participants of the SEARCH program study. We evaluated 367 cases of ductal adenocarcinoma and 821 controls for associations between pancreatic cancer and age at menarche, age at menopause, number of pregnancies, exogenous hormone use, and history of gynaecologic surgery. Among directly interviewed and proxy participants, we found a statistically significant association for having age of menarche at 11 years or younger compared with menarche at ages 12-13 years (OR = 1.8, 95% CI = 1.1-3.1). This result was consistent, but not statistically significant, among three of the four studies analyzed, and when the data were analyzed separately by response status (direct vs. proxy interviews). No other menstrual or reproductive factors were associated with pancreatic cancer risk in this study. In conclusion, earlier age at menarche may be weakly associated with pancreatic cancer, but it seems unlikely that menstrual and reproductive factors play more than only a minor role in pancreatic cancer. Additional analyses in large prospective study populations and in pooled studies may help to clarify remaining inconsistencies.

24 Article Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium. 2009

Lynch, Shannon M / Vrieling, Alina / Lubin, Jay H / Kraft, Peter / Mendelsohn, Julie B / Hartge, Patricia / Canzian, Federico / Steplowski, Emily / Arslan, Alan A / Gross, Myron / Helzlsouer, Kathy / Jacobs, Eric J / LaCroix, Andrea / Petersen, Gloria / Zheng, Wei / Albanes, Demetrius / Amundadottir, Laufey / Bingham, Sheila A / Boffetta, Paolo / Boutron-Ruault, Marie-Christine / Chanock, Stephen J / Clipp, Sandra / Hoover, Robert N / Jacobs, Kevin / Johnson, Karen C / Kooperberg, Charles / Luo, Juhua / Messina, Catherine / Palli, Domenico / Patel, Alpa V / Riboli, Elio / Shu, Xiao-Ou / Rodriguez Suarez, Laudina / Thomas, Gilles / Tjønneland, Anne / Tobias, Geoffrey S / Tong, Elissa / Trichopoulos, Dimitrios / Virtamo, Jarmo / Ye, Weimin / Yu, Kai / Zeleniuch-Jacquette, Anne / Bueno-de-Mesquita, H Bas / Stolzenberg-Solomon, Rachael Z. ·National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA. lynchs@mail.nih.gov ·Am J Epidemiol · Pubmed #19561064.

ABSTRACT: Smoking is an established risk factor for pancreatic cancer; however, detailed examination of the association of smoking intensity, smoking duration, and cumulative smoking dose with pancreatic cancer is limited. The authors analyzed pooled data from the international Pancreatic Cancer Cohort Consortium nested case-control study (1,481 cases, 1,539 controls). Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Smoking intensity effects were examined with an excess odds ratio model that was linear in pack-years and exponential in cigarettes smoked per day and its square. When compared with never smokers, current smokers had a significantly elevated risk (odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.38, 2.26). Risk increased significantly with greater intensity (> or =30 cigarettes/day: OR = 1.75, 95% CI: 1.27, 2.42), duration (> or =50 years: OR = 2.13, 95% CI: 1.25, 3.62), and cumulative smoking dose (> or =40 pack-years: OR = 1.78, 95% CI: 1.35, 2.34). Risk more than 15 years after smoking cessation was similar to that for never smokers. Estimates of excess odds ratio per pack-year declined with increasing intensity, suggesting greater risk for total exposure delivered at lower intensity for longer duration than for higher intensity for shorter duration. This finding and the decline in risk after smoking cessation suggest that smoking has a late-stage effect on pancreatic carcinogenesis.

25 Article Ethanol intake and the risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). 2009

Rohrmann, Sabine / Linseisen, Jakob / Vrieling, Alina / Boffetta, Paolo / Stolzenberg-Solomon, Rachael Z / Lowenfels, Albert B / Jensen, Majken K / Overvad, Kim / Olsen, Anja / Tjonneland, Anne / Boutron-Ruault, Marie-Christine / Clavel-Chapelon, Francoise / Fagherazzi, G / Misirli, Gesthimani / Lagiou, Pagona / Trichopoulou, Antonia / Kaaks, Rudolf / Bergmann, Manuela M / Boeing, Heiner / Bingham, Sheila / Khaw, Kay-Tee / Allen, Naomi / Roddam, Andrew / Palli, Domenico / Pala, Valeria / Panico, Salvatore / Tumino, Rosario / Vineis, Paolo / Peeters, Petra H M / Hjartåker, Anette / Lund, Eiliv / Redondo Cornejo, Ma Luisa / Agudo, Antonio / Arriola, Larraitz / Sánchez, Maria-José / Tormo, María-José / Barricarte Gurrea, Aurelio / Lindkvist, Björn / Manjer, Jonas / Johansson, Ingegerd / Ye, Weimin / Slimani, Nadia / Duell, Eric J / Jenab, Mazda / Michaud, Dominique S / Mouw, Traci / Riboli, Elio / Bueno-de-Mesquita, H Bas. ·Division of Clinical Epidemiology, German Cancer Research Centre, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. s.rohrmann@dkfz.de ·Cancer Causes Control · Pubmed #19145468.

ABSTRACT: OBJECTIVE: To examine the association of baseline and lifetime ethanol intake with cancer of the pancreas in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in this analysis were 478,400 subjects, of whom detailed information on the intake of alcoholic beverages at baseline and over lifetime was collected between 1992 and 2000. During a median follow-up time of 8.9 years, 555 non-endocrine pancreatic cancer cases were observed. Multivariate Cox proportional hazard models were used to examine the association of ethanol intake at recruitment and average lifetime ethanol intake and pancreatic cancer adjusting for smoking, height, weight, and history of diabetes. RESULTS: Overall, neither ethanol intake at recruitment (relative risk (RR) = 0.94, 95% confidence interval (CI) 0.69-1.27 comparing 30+ g/d vs. 0.1-4.9 g/d) nor average lifetime ethanol intake (RR = 0.95, 95% CI 0.65-1.39) was associated with pancreatic cancer risk. High lifetime ethanol intake from spirits/liquor at recruitment tended to be associated with a higher risk (RR = 1.40, 95% CI 0.93-2.10 comparing 10+ g/d vs. 0.1-4.9 g/d), but no associations were observed for wine and beer consumption. CONCLUSION: These results suggest no association of alcohol consumption with the risk of pancreatic cancer.

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