Past Medical History and Pancreatic Cancer Risk: Results From a Multicenter Case-Control Study

Received 24 July 2009; accepted 25 November 2009.

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.

Key Words: Allergies, Diabetes, Multicenter Case-Control Study, Pancreas Cancer, Pancreatitis, Past Medical History

Selected Abbreviations and Acronyms: OR, odds ratio, 95% CI, 95% confidence interval, BMI, body mass index

a Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

b Department of Surgery, New York Medical College, Valhalla, New York

c National Institute for Public Health and the Environment (RIVM), Bilthoven, and Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands

d Epidemiology Research Unit, Research Centre (CRCHUM), Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada

e Division of Human Nutrition, Commonwealth Scientific and Industrial Research Organization, Adelaide, South Australia, Australia

f Department of Cancer Control and Epidemiology, Cancer Center-Curie-Sklodowsks Institute, Warszawa, Poland

g Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

h Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain

i International Agency for Research on Cancer, Lyon Cedex, and France

j International Prevention Research Institute, Lyon, France

PII: S1047-2797(09)00366-4

doi:10.1016/j.annepidem.2009.11.010

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