In a hospital based case-control study of pancreatic cancer in Ontario and Quebec, a total of 174 incident pancreatic cancer cases and 136 healthy controls were compared for their family history of cancer. Information regarding the ages and sites of cancer was taken for 966 first-degree relatives of the cancer cases and for 903 first-degree relatives of the controls. A total of 150 cancer cases were reported among the relatives of the cases, compared to 122 cases among the relatives of the controls (relative risk 1.15; p ؍ 0.23). Pancreatic cancer was the only site statistically in excess in the case relatives, compared to the control relatives (relative risk ؍ 5.0; p ؍ 0.01). The lifetime risk of pancreatic cancer was 4.7% for the first-degree relatives of the pancreatic cancer cases. The risk was 7.2% for relatives of cases diagnosed before age 60, and was 12.3% for relatives of patients with multiple primary cancers (all ages). These individuals comprise a high-risk group for pancreatic cancer and might benefit from enhanced surveillance or chemoprevention. Familial site-specific pancreatic cancer appears to be a distinct genetic entity, but contributes only modestly to the total burden of pancreatic cancer. © 2002 Wiley-Liss, Inc. Pancreatic cancer is 1 of the leading causes of death from cancer in Canada and is among the cancer types with the highest casefatality rate. Pancreatic cancer is diagnosed in roughly equal numbers in males and females. There are few known risk factors for pancreatic cancer and few preventive or screening options are available for those considered to be at high risk. 1 Smoking is the most important and most consistent environmental risk factor for pancreatic cancer; the risk is increased roughly 3-fold for men and women with heavy cigarette consumption. 2,3 Several dietary factors have been reported to be protective, including fresh fruits and vegetables, dietary fibre and vitamin C. 4,5 Other foods have been reported to increase the cancer risk, including salted and smoked foods, fried foods and refined sugar. 5 It is clear that familial factors are also involved in susceptibility to pancreatic cancer. 6 Several case-control studies have reported that patients with pancreatic cancer are more likely to have a relative affected with pancreatic cancer than are healthy controls. Falk et al. 7 estimated the relative risk of pancreatic cancer to be 5.3 for first-degree relatives of patients with pancreatic cancer. Ghadirian et al. 8 reported that 7.8% of French-Canadian patients with pancreatic cancer had an affected relative, compared to 0.6% of the controls. In an Italian study, the estimated relative risk for pancreatic cancer was 2.8 for those with an affected first-degree relative, after adjustment for smoking, alcohol, diet and selected medical factors. 9 Many families with multiple individuals affected with pancreatic cancer have been described. 8,10,11 In many families it appears that pancreatic cancer is the only site in excess. There are several familial cancer synd...
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