Non-linear dose–response relationship between cigarette smoking and pancreatic cancer risk: Evidence from a meta-analysis of 42 observational studies

Zou, Li; Zhong, Rong; Shen, Na; Chen, Wei; Zhu, Beibei; Ke, Juntao; Lu, Xuzai; Zhang, Ti; Lou, Jiao; Wang, Zhenling; Liu, Li; Qi, Lu; Miao, Xiaoping

doi:10.1016/j.ejca.2013.08.014

Cited by 60 publications

(44 citation statements)

References 59 publications

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“…Although smoking is clearly one of the most preventable causes of pancreatic carcinoma development1819, little is known about the role of smoking in the development of PNET. Several recently conducted case-control studies showed no positive association between ever smoking and the development of NETs in the pancreas14, rectum20 and small intestine21.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Sporadic Pancreatic Neuroendocrine Tumors: A Case-Control Study

Ben

Zhong

Fei

et al. 2016

Sci Rep

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The current study examined risk factors for sporadic pancreatic neuroendocrine tumors (PNETs), including smoking, alcohol use, first-degree family history of any cancer (FHC), and diabetes in the Han Chinese ethnic group. In this clinic-based case-control analysis on 385 patients with sporadic PNETs and 614 age- and sex-matched controls, we interviewed subjects using a specific questionnaire on demographics and potential risk factors. An unconditional multivariable logistic regression analysis was used to estimate adjusted odds ratios (AORs). No significant differences were found between patients and controls in terms of demographic variables. Most of the patients with PNETs had well-differentiated PNETs (G1, 62.9%) and non-advanced European Neuroendocrine Tumor Society (ENETS) stage (stage I or II, 83.9%). Ever/heavy smoking, a history of diabetes and a first-degree FHC were independent risk factors for non-functional PNETs. Only heavy drinking was found to be an independent risk factor for functional PNETs (AOR = 1.87; 95% confidence interval [CI], 1.01–3.51). Ever/heavy smoking was also associated with advanced ENETS staging (stage III or IV) at the time of diagnosis. This study identified first-degree FHC, ever/heavy smoking, and diabetes as risk factors for non-functional PNETs, while heavy drinking as a risk factor for functional PNETs.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Sporadic Pancreatic Neuroendocrine Tumors: A Case-Control Study

Ben

Zhong

Fei

et al. 2016

Sci Rep

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“…Smoking, diabetes, and obesity are established risk factors for pancreatic cancer. 3–5 Prevalence of overweight and obesity has rapidly increased during the last 2 decades. Obesity and overweight are commonly measured by body mass index (BMI), which is defined as weight in kilograms divided by height in meters squared.…”

Section: Introductionmentioning

confidence: 99%

Effect of Body Mass Index on Overall Survival of Pancreatic Cancer

Shi

Yang

et al. 2016

Medicine

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Although obesity has been identified as a risk factor for pancreatic cancer, the important question of whether obesity influences the prognosis of pancreatic cancer has not been explicated thoroughly. We therefore performed a meta-analysis to investigate the association between body mass index (BMI) and survival outcomes of patients with pancreatic cancer.Studies that described the relationship between BMI and overall survival (OS) of pancreatic cancer were searched in PubMed, Embase, Ovid, and Cochrane Library Databases from the earliest available date to May 12, 2015. Hazard ratios (HRs) for OS in each BMI category from individual studies were extracted and pooled by a random-effect model. Dose–response meta-analysis was also performed to estimate summary HR and 95% confidence interval (CI) for every 5-unit increment. Publication bias was evaluated by Begg funnel plot and Egger linear regression test.Ten relevant studies involving 6801 patients were finally included in the meta-analysis. Results showed that obesity in adulthood significantly shortened OS of pancreatic cancer patients (HR: 1.29, 95% CI: 1.17–1.41), whereas obesity at diagnosis was not associated with any increased risk of death (HR: 1.10, 95% CI: 0.78–1.42). For every 5-kg/m2 increment in adult BMI, the summary HR was 1.11 (95% CI: 1.05–1.18) for death risk of pancreatic cancer. However, no dose–response relationship was found in the BMI at diagnosis. Egger regression test and Begg funnel plot both revealed no obvious risk of publication bias.In conclusion, increased adult BMI is associated with increased risk of death for pancreatic cancer patients, which suggested that obesity in adulthood may be an important prognostic factor that indicates an abbreviated survival from pancreatic cancer. More studies are needed to validate this finding, and the mechanism behind the observation should be evaluated in further studies.

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“…The results of meta-analysis of tobacco risk and pancreatic cancer from 82 studies revealed that there was an estimated 75% increased risk for pancreatic cancer in smokers versus non-smokers. The scientific literature also supported the fact that smoking cessation can reduce this risk by up to 50%, at all age groups but is particularly important for the prevention of early onset of pancreatic cancer [36]. The cigarette smoke comprises well known sixty carcinogens, that is responsible for the initiation of tumrogenesis [37].…”

Section: Smokingmentioning

confidence: 99%

Role of Probiotics in Pancreatic Cancer Prevention: The Prospects and Challenges

Singhal¹,

Mukherjee²

2016

ABB

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Pancreatic cancer is expressed as a disorder of chaos that leads to impairment in biochemical and metabolic physiology of pancreas. It is considered as the most intractable and fatal among all gastrointestinal (GI) cancers. The early occurrence of metastatic spread and the development of intrinsic and acquired resistance during drug treatment limit its prognosis at the right time. The universalized treatment involves surgical resection in which only a minority (<20%) of patients qualify due to advanced stage of disease at the time of diagnosis. Despite the rigorous technological developments in understanding the molecular mechanism of pancreatic cancer, no significant advances in efficacy of chemotherapeutic treatment have been arisen till date and still present challenges to overcome. That leads to the scientists to undergo exhaustive research to find an alternative treatment and increasing focus have been given on the studies of symbiotic relationships between microbiota and host which confers benefits to the host in many key aspects of life and form a synergistic harmony so called "super-organism". The perturbations in the regulatory circuits of the host that control homeostasis, or alterations of the microbiome, through environmental changes (infection, diet or lifestyle), may disturb this symbiotic relationship and favors carcinogenesis in the pancreas. Research studies speculating convincing evidence that, among the gut microbiota, probiotics have demonstrated their potential role in the prevention of all stages of cancer development, but the critical question has been arisen that Can probiotics be used as preventive targets for pancreatic cancer? Thus, the efforts have been directed towards to summarize the prospective and challenging role of probiotics as preventive approach for pancreatic cancer. Though prospects of probiotics in prevention of pancreatic cancer are being great challenge among research community therefore, more rigorous and well-designed in vitro, animal and clinical studies are required for worthy manifestations.

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Non-linear dose–response relationship between cigarette smoking and pancreatic cancer risk: Evidence from a meta-analysis of 42 observational studies

Cited by 60 publications

References 59 publications

Risk Factors for Sporadic Pancreatic Neuroendocrine Tumors: A Case-Control Study

Risk Factors for Sporadic Pancreatic Neuroendocrine Tumors: A Case-Control Study

Effect of Body Mass Index on Overall Survival of Pancreatic Cancer

Role of Probiotics in Pancreatic Cancer Prevention: The Prospects and Challenges

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