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Pancreatic Neoplasms: HELP
Articles by Piet A. van den Brandt
Based on 11 articles published since 2010
(Why 11 articles?)
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Between 2010 and 2020, P. A. van den Brandt wrote the following 11 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Dairy products and pancreatic cancer risk: a pooled analysis of 14 cohort studies. 2014

Genkinger, J M / Wang, M / Li, R / Albanes, D / Anderson, K E / Bernstein, L / van den Brandt, P A / English, D R / Freudenheim, J L / Fuchs, C S / Gapstur, S M / Giles, G G / Goldbohm, R A / Håkansson, N / Horn-Ross, P L / Koushik, A / Marshall, J R / McCullough, M L / Miller, A B / Robien, K / Rohan, T E / Schairer, C / Silverman, D T / Stolzenberg-Solomon, R Z / Virtamo, J / Willett, W C / Wolk, A / Ziegler, R G / Smith-Warner, S A. ·Department of Epidemiology, Mailman School of Public Health, Columbia University, New York jg3081@columbia.edu. · Department of Epidemiology, Harvard School of Public Health, Boston Department of Biostatistics, Harvard School of Public Health, Boston. · Department of Epidemiology, Harvard School of Public Health, Boston. · Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda. · Division of Epidemiology and Community Health, School of Public Health, Masonic Cancer Center, University of Minnesota, Minneapolis. · Division of Cancer Etiology, Department of Population Science, Beckman Research Institute and City of Hope National Medical Center, Duarte, USA. · Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands. · Cancer Epidemiology Centre, Cancer Council of Victoria, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. · Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo. · Division of Medical Oncology, Dana-Farber Cancer Institute, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston. · Epidemiology Research Program, American Cancer Society, Atlanta, USA. · Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands. · Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. · Cancer Prevention Institute of California, Fremont, USA. · Department of Social and Preventive Medicine, University of Montreal, Montreal. · Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. · Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, Washington, DC. · Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA. · Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. · Department of Epidemiology, Harvard School of Public Health, Boston Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA. · Department of Epidemiology, Harvard School of Public Health, Boston Department of Nutrition, Harvard School of Public Health, Boston, USA. ·Ann Oncol · Pubmed #24631943.

ABSTRACT: Pancreatic cancer has few early symptoms, is usually diagnosed at late stages, and has a high case-fatality rate. Identifying modifiable risk factors is crucial to reducing pancreatic cancer morbidity and mortality. Prior studies have suggested that specific foods and nutrients, such as dairy products and constituents, may play a role in pancreatic carcinogenesis. In this pooled analysis of the primary data from 14 prospective cohort studies, 2212 incident pancreatic cancer cases were identified during follow-up among 862 680 individuals. Adjusting for smoking habits, personal history of diabetes, alcohol intake, body mass index (BMI), and energy intake, multivariable study-specific hazard ratios (MVHR) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazards models and then pooled using a random effects model. There was no association between total milk intake and pancreatic cancer risk (MVHR = 0.98, 95% CI = 0.82-1.18 comparing ≥500 with 1-69.9 g/day). Similarly, intakes of low-fat milk, whole milk, cheese, cottage cheese, yogurt, and ice-cream were not associated with pancreatic cancer risk. No statistically significant association was observed between dietary (MVHR = 0.96, 95% CI = 0.77-1.19) and total calcium (MVHR = 0.89, 95% CI = 0.71-1.12) intake and pancreatic cancer risk overall when comparing intakes ≥1300 with <500 mg/day. In addition, null associations were observed for dietary and total vitamin D intake and pancreatic cancer risk. Findings were consistent within sex, smoking status, and BMI strata or when the case definition was limited to pancreatic adenocarcinoma. Overall, these findings do not support the hypothesis that consumption of dairy foods, calcium, or vitamin D during adulthood is associated with pancreatic cancer risk.

2 Review Folate intake and risk of pancreatic cancer: pooled analysis of prospective cohort studies. 2011

Bao, Ying / Michaud, Dominique S / Spiegelman, Donna / Albanes, Demetrius / Anderson, Kristin E / Bernstein, Leslie / van den Brandt, Piet A / English, Dallas R / Freudenheim, Jo L / Fuchs, Charles S / Giles, Graham G / Giovannucci, Edward / Goldbohm, R Alexandra / Håkansson, Niclas / Horn-Ross, Pamela L / Jacobs, Eric J / Kitahara, Cari M / Marshall, James R / Miller, Anthony B / Robien, Kim / Rohan, Thomas E / Schatzkin, Arthur / Stevens, Victoria L / Stolzenberg-Solomon, Rachael Z / Virtamo, Jarmo / Wolk, Alicja / Ziegler, Regina G / Smith-Warner, Stephanie A. ·Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. ·J Natl Cancer Inst · Pubmed #22034634.

ABSTRACT: BACKGROUND: Epidemiological studies evaluating the association between folate intake and risk of pancreatic cancer have produced inconsistent results. The statistical power to examine this association has been limited in previous studies partly because of small sample size and limited range of folate intake in some studies. METHODS: We analyzed primary data from 14 prospective cohort studies that included 319,716 men and 542,948 women to assess the association between folate intake and risk of pancreatic cancer. Folate intake was assessed through a validated food-frequency questionnaire at baseline in each study. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and then pooled using a random effects model. All statistical tests were two-sided. RESULTS: During 7-20 years of follow-up across studies, 2195 pancreatic cancers were identified. No association was observed between folate intake and risk of pancreatic cancer in men and women (highest vs lowest quintile: dietary folate intake, pooled multivariable RR = 1.06, 95% CI = 0.90 to 1.25, P(trend) = .47; total folate intake [dietary folate and supplemental folic acid], pooled multivariable RR = 0.96, 95% CI = 0.80 to 1.16, P(trend) = .90). No between-study heterogeneity was observed (for dietary folate, P(heterogeneity) = .15; for total folate, P(heterogeneity) = .22). CONCLUSION: Folate intake was not associated with overall risk of pancreatic cancer in this large pooled analysis.

3 Article Mediterranean diet adherence and risk of pancreatic cancer: A pooled analysis of two Dutch cohorts. 2019

Schulpen, Maya / Peeters, Petra H / van den Brandt, Piet A. ·Maastricht University Medical Centre, GROW - School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht, The Netherlands. · University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands. · Maastricht University Medical Centre, CAPHRI - School for Public Health and Primary Care, Department of Epidemiology, Maastricht, The Netherlands. ·Int J Cancer · Pubmed #30230536.

ABSTRACT: 3w?>Studies investigating the association of Mediterranean diet (MD) adherence with pancreatic cancer risk are limited and had inconsistent results. We examined the association between MD adherence and pancreatic cancer incidence by pooling data from the Netherlands Cohort Study (NLCS, 120,852 subjects) and the Dutch cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-NL, 40,011 subjects). MD adherence was assessed using alternate and modified Mediterranean diet scores (aMED and mMED, respectively), including and excluding alcohol. After median follow-ups of 20.3 (NLCS) and 19.2 (EPIC-NL) years, 449 microscopically confirmed pancreatic cancer (MCPC) cases were included in study-specific multivariable Cox models. Study-specific estimates were pooled using a random-effects model. MD adherence was not significantly associated with MCPC risk in pooled and study-specific analyses, regardless of sex and MD score. Pooled hazard ratios (95% confidence interval) for high (6-8) compared to low (0-3) values of mMED excluding alcohol were 0.66 (0.40-1.10) in men and 0.94 (0.63-1.40) in women. In never smokers, mMED excluding alcohol seemed to be inversely associated with MCPC risk (nonsignificant). However, no association was observed in ever smokers (p

4 Article Total Nut, Tree Nut, Peanut, and Peanut Butter Consumption and the Risk of Pancreatic Cancer in the Netherlands Cohort Study. 2018

Nieuwenhuis, Lisette / van den Brandt, Piet A. ·Care and Public Health Research Institute (CAPHRI), Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands. l.nieuwenhuis@maastrichtuniversity.nl. · Care and Public Health Research Institute (CAPHRI), Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands. · GROW-School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands. ·Cancer Epidemiol Biomarkers Prev · Pubmed #29358224.

ABSTRACT:

5 Article Diabetes type II, other medical conditions and pancreatic cancer risk: a prospective study in The Netherlands. 2013

Eijgenraam, P / Heinen, M M / Verhage, B A J / Keulemans, Y C / Schouten, L J / van den Brandt, P A. ·1] School for Oncology and Developmental Biology (GROW), Department of Epidemiology, Maastricht University Medical Centre+, Peter Debyeplein 1, 6229 HA, Maastricht, The Netherlands [2] Department of Biochemistry, Maastricht University Medical Centre+, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands. ·Br J Cancer · Pubmed #24149173.

ABSTRACT: BACKGROUND: To date, only a few risk factors for pancreatic cancer have been established. We examined prospectively relations between several medical conditions and pancreatic cancer incidence. METHODS: In 1986, 120 852 participants completed a baseline questionnaire on cancer risk factors, including several self-reported physician diagnosed medical conditions. At baseline, a random subcohort of 5000 participants was selected using a case-cohort approach for analysis. After 16.3 years of follow-up, 448 pancreatic cancer cases (63% microscopically confirmed) were available for analysis. RESULTS: Diabetes mellitus type II and hepatitis were positively associated with pancreatic cancer risk (multivariable-adjusted hazard ratio: 1.79; 95% confidence interval: 1.12-2.87 and hazard ratio: 1.37; 95% confidence interval: 1.04-1.81, respectively). Furthermore, a positive trend in risk with increasing years of diagnosis of diabetes (P=0.004) and of hepatitis (P=0.02) was observed. However, an inverse association was observed between hypertension and pancreatic cancer risk, this was found among microscopically confirmed cases only (hazard ratio: 0.66; 95% confidence interval: 0.49-0.90), while years since diagnosis of hypertension significantly decreased cancer risk (P for trend=0.02). CONCLUSION: In this prospective study, a positive association was observed between self-reported physician diagnosed diabetes mellitus type II and hepatitis and pancreatic cancer risk, whereas an inverse association was observed with hypertension.

6 Article Intake of fruits and vegetables and risk of pancreatic cancer in a pooled analysis of 14 cohort studies. 2012

Koushik, Anita / Spiegelman, Donna / Albanes, Demetrius / Anderson, Kristin E / Bernstein, Leslie / van den Brandt, Piet A / Bergkvist, Leif / English, Dallas R / Freudenheim, Jo L / Fuchs, Charles S / Genkinger, Jeanine M / Giles, Graham G / Goldbohm, R Alexandra / Horn-Ross, Pamela L / Männistö, Satu / McCullough, Marjorie L / Millen, Amy E / Miller, Anthony B / Robien, Kim / Rohan, Thomas E / Schatzkin, Arthur / Shikany, James M / Stolzenberg-Solomon, Rachael Z / Willett, Walter C / Wolk, Alicja / Ziegler, Regina G / Smith-Warner, Stephanie A. ·University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada. anita.koushik@umontreal.ca ·Am J Epidemiol · Pubmed #22875754.

ABSTRACT: Fruit and vegetable intake may protect against pancreatic cancer, since fruits and vegetables are rich in potentially cancer-preventive nutrients. Most case-control studies have found inverse associations between fruit and vegetable intake and pancreatic cancer risk, although bias due to reporting error cannot be ruled out. In most prospective studies, inverse associations have been weaker and imprecise because of small numbers of cases. The authors examined fruit and vegetable intake in relation to pancreatic cancer risk in a pooled analysis of 14 prospective studies from North America, Europe, and Australia (study periods between 1980 and 2005). Relative risks and 2-sided 95% confidence intervals were estimated separately for the 14 studies using the Cox proportional hazards model and were then pooled using a random-effects model. Of 862,584 men and women followed for 7-20 years, 2,212 developed pancreatic cancer. The pooled multivariate relative risks of pancreatic cancer per 100-g/day increase in intake were 1.01 (95% confidence interval (CI): 0.99, 1.03) for total fruits and vegetables, 1.01 (95% CI: 0.99, 1.03) for total fruits, and 1.02 (95% CI: 0.99, 1.06) for total vegetables. Associations were similar for men and women separately and across studies. These results suggest that fruit and vegetable intake during adulthood is not associated with a reduced pancreatic cancer risk.

7 Article Coffee, tea, and sugar-sweetened carbonated soft drink intake and pancreatic cancer risk: a pooled analysis of 14 cohort studies. 2012

Genkinger, Jeanine M / Li, Ruifeng / Spiegelman, Donna / Anderson, Kristin E / Albanes, Demetrius / Bergkvist, Leif / Bernstein, Leslie / Black, Amanda / van den Brandt, Piet A / English, Dallas R / Freudenheim, Jo L / Fuchs, Charles S / Giles, Graham G / Giovannucci, Edward / Goldbohm, R Alexandra / Horn-Ross, Pamela L / Jacobs, Eric J / Koushik, Anita / Männistö, Satu / Marshall, James R / Miller, Anthony B / Patel, Alpa V / Robien, Kim / Rohan, Thomas E / Schairer, Catherine / Stolzenberg-Solomon, Rachael / Wolk, Alicja / Ziegler, Regina G / Smith-Warner, Stephanie A. ·Mailman School of Public Health, 722 w 168th St, Rm 803, New York, NY 10032, USA. jg3081@columbia.edu ·Cancer Epidemiol Biomarkers Prev · Pubmed #22194529.

ABSTRACT: BACKGROUND: Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous. METHODS: In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model. RESULTS: No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81-1.48 comparing ≥900 to <0 g/d; 237g ≈ 8oz), tea (MVRR = 0.96; 95% CI, 0.78-1.16 comparing ≥400 to 0 g/d; 237g ≈ 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98-1.46 comparing ≥250 to 0 g/d; 355g ≈ 12oz; P value, test for between-studies heterogeneity > 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02-1.12). CONCLUSION AND IMPACT: Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB.

8 Article Intake of vegetables, fruits, carotenoids and vitamins C and E and pancreatic cancer risk in The Netherlands Cohort Study. 2012

Heinen, Mirjam M / Verhage, Bas A J / Goldbohm, R Alexandra / van den Brandt, Piet A. ·Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands. mirjam.heinen@maastrichtuniversity.nl ·Int J Cancer · Pubmed #21328344.

ABSTRACT: Epidemiological data investigating the relation between fruit and vegetable consumption and pancreatic cancer risk have shown inconsistent results so far. Most case-control studies observed an inverse association with total fruit and vegetable consumption, whereas results from most cohort studies have largely been null. We examined prospectively the relation between pancreatic cancer risk and intake of vegetables, fruits, carotenoids and vitamins C and E. The Netherlands Cohort Study consisted of 120,852 men and women who completed a questionnaire at baseline in 1986, including a validated 150-item food-frequency questionnaire. After 16.3 years of follow-up, 423 cases were available for analysis. Total vegetable and total fruit consumption were not associated with pancreatic cancer risk (highest vs. lowest quintile, multivariable-adjusted hazard rate ratio = 1.23, 95% confidence interval: 0.86-1.75 and multivariable-adjusted hazard rate ratio = 0.90, 95% confidence interval: 0.66-1.24, respectively). Also, for cooked vegetables, raw vegetables and vegetables and fruits classified into subgroups, no associations were observed. Dietary carotenoids, vitamin C and E intake and supplements containing vitamin C or E were not associated with pancreatic cancer risk. The results were not modified by sex, smoking status and body mass index. In conclusion, we observed no association between a high consumption of vegetables and fruits and pancreatic cancer risk in this large cohort study, which is in agreement with previous prospective studies. Furthermore, we observed no association between the intake of carotenoids, vitamins and vitamin supplements and pancreatic cancer risk.

9 Article Physical activity, energy restriction, and the risk of pancreatic cancer: a prospective study in the Netherlands. 2011

Heinen, Mirjam M / Verhage, Bas A J / Goldbohm, R Alexandra / Lumey, L H / van den Brandt, Piet A. ·Nutrition and Toxicology Research Institute Maastricht, Department of Epidemiology, Maastricht University Medical Centre+, Netherlands. mirjam.heinen@maastrichtuniversity.nl ·Am J Clin Nutr · Pubmed #21955648.

ABSTRACT: BACKGROUND: Because of their influence on insulin concentrations, we hypothesized that both physical activity and energy restriction may reduce the risk of pancreatic cancer. OBJECTIVE: We examined the associations between physical activity, proxies for energy restriction, and pancreatic cancer risk. DESIGN: The Netherlands Cohort Study consisted of 120,852 individuals who completed a baseline questionnaire in 1986. After 13.3 y of follow-up, 408 cases were available for analysis. Self-reported information on physical activity was collected. Three indicators were used as proxies for energy restriction: father's employment status during the Economic Depression (1932-1940) and place of residence during the World War II years (1940-1944) and the Hunger winter (1944-1945). RESULTS: For past sports activities, we observed a significantly decreased risk of pancreatic cancer (HR: 0.80; 95% CI: 0.64, 0.99). Proxies for energy restriction were not related to pancreatic cancer risk. When the results for energy restriction were stratified by height, a significant multiplicative interaction was observed for the Economic Depression period (P = 0.002). Shorter individuals (height less than the sex-specific median adult height) with an unemployed father during the Economic Depression period had a significantly lower cancer risk (HR: 0.31; 95% CI: 0.14, 0.66) than did taller individuals with an employed father. No significant interactions were observed for exposure to energy restriction during the World War II years and the Hunger winter. CONCLUSIONS: Our results suggest a modestly decreased risk of pancreatic cancer associated with past sports activity. With respect to proxies for energy restriction, our findings suggest that shorter individuals exposed to energy restriction during adolescence may have a reduced risk, whereas taller individuals may not.

10 Article A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. 2011

Genkinger, Jeanine M / Spiegelman, Donna / Anderson, Kristin E / Bernstein, Leslie / van den Brandt, Piet A / Calle, Eugenia E / English, Dallas R / Folsom, Aaron R / Freudenheim, Jo L / Fuchs, Charles S / Giles, Graham G / Giovannucci, Edward / Horn-Ross, Pamela L / Larsson, Susanna C / Leitzmann, Michael / Männistö, Satu / Marshall, James R / Miller, Anthony B / Patel, Alpa V / Rohan, Thomas E / Stolzenberg-Solomon, Rachael Z / Verhage, Bas A J / Virtamo, Jarmo / Willcox, Bradley J / Wolk, Alicja / Ziegler, Regina G / Smith-Warner, Stephanie A. ·Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. jg3081@columbia.edu ·Int J Cancer · Pubmed #21105029.

ABSTRACT: Epidemiologic studies of pancreatic cancer risk have reported null or nonsignificant positive associations for obesity, while associations for height have been null. Waist and hip circumference have been evaluated infrequently. A pooled analysis of 14 cohort studies on 846,340 individuals was conducted; 2,135 individuals were diagnosed with pancreatic cancer during follow-up. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were calculated by Cox proportional hazards models, and then pooled using a random effects model. Compared to individuals with a body mass index (BMI) at baseline between 21-22.9 kg/m(2) , pancreatic cancer risk was 47% higher (95%CI:23-75%) among obese (BMI ≥ 30 kg/m(2) ) individuals. A positive association was observed for BMI in early adulthood (pooled multivariate [MV]RR = 1.30, 95%CI = 1.09-1.56 comparing BMI ≥ 25 kg/m(2) to a BMI between 21 and 22.9 kg/m(2) ). Compared to individuals who were not overweight in early adulthood (BMI < 25 kg/m(2) ) and not obese at baseline (BMI < 30 kg/m(2) ), pancreatic cancer risk was 54% higher (95%CI = 24-93%) for those who were overweight in early adulthood and obese at baseline. We observed a 40% higher risk among individuals who had gained BMI ≥ 10 kg/m(2) between BMI at baseline and younger ages compared to individuals whose BMI remained stable. Results were either similar or slightly stronger among never smokers. A positive association was observed between waist to hip ratio (WHR) and pancreatic cancer risk (pooled MVRR = 1.35 comparing the highest versus lowest quartile, 95%CI = 1.03-1.78). BMI and WHR were positively associated with pancreatic cancer risk. Maintaining normal body weight may offer a feasible approach to reducing morbidity and mortality from pancreatic cancer.

11 Article Active and passive smoking and the risk of pancreatic cancer in the Netherlands Cohort Study. 2010

Heinen, Mirjam M / Verhage, Bas A J / Goldbohm, R Alexandra / van den Brandt, Piet A. ·Department of Epidemiology, Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands. mirjam.heinen@epid.unimaas.nl ·Cancer Epidemiol Biomarkers Prev · Pubmed #20501775.

ABSTRACT: BACKGROUND: To date, cigarette smoking is the most consistent risk factor for pancreatic cancer. We prospectively examined the role of active cigarette smoking, smoking cessation, and passive smoking as determinants for pancreatic cancer. METHODS: The Netherlands Cohort Study consisted of 120,852 men and women who completed a baseline questionnaire in 1986. After 16.3 years of follow-up, 520 incident pancreatic cancer cases were available for analysis. A case-cohort approach was employed using the person-years of follow-up of a random subcohort (n = 5,000), which was chosen immediately after baseline. RESULTS: Compared with never cigarette smokers, both former and current cigarette smokers had an increased pancreatic cancer risk [multivariable-adjusted hazard rate ratio (HR), 1.34; 95% confidence interval (CI), 1.02-1.75 and HR, 1.82; 95% CI, 1.40-2.38, respectively]. We observed an increased pancreatic cancer risk per increment of 10 years of smoking (HR, 1.15; 95% CI, 1.08-1.22) and an HR of 1.08 per increment of 10 cigarettes/d (95% CI, 0.98-1.19). Quitting smoking gradually reduced pancreatic cancer risk and approached unity after > or = 20 years of quitting. No association was observed for passive smoking exposure and pancreatic cancer risk in women; in men, this association was not investigated because >90% of the men were ever smokers. CONCLUSIONS: Overall, our findings confirmed that cigarette smoking is an important risk factor for pancreatic cancer, whereas quitting smoking reduced risk. No association was observed between passive smoking exposure and pancreatic cancer risk in women. IMPACT: Quitting smoking would benefit the burden on pancreatic cancer incidence.