Several studies have investigated a possible association between the ABO blood group and the risk of pancreatic cancer (PC), but this association has not been fully evaluated in Asian populations. The present study aimed to assess the impact of genotype-derived ABO blood types, particularly ABO alleles, on the risk of PC in a Japanese population. We conducted a case-control study using 185 PC and 1465 control patients who visited Aichi Cancer Center in Nagoya, Japan. Using rs8176719 as a marker for the O allele, and rs8176746 and rs8176747 for the B allele, all participants' two ABO alleles were inferred. The impact of ABO blood type on PC risk was examined by multivariate analysis, with adjustment for potential confounders to estimate odds ratios (OR) and 95% confidence intervals (CI). An increased risk of PC was observed with the addition of any non-O allele (trend P = 0.012). Compared with subjects with the OO genotype, those with AO and BB genotypes had significantly increased OR of 1.67 (CI, 1.08-2.57) and 3.28 (CI, 1.38-7.80), respectively. Consistent with earlier reports showing a higher risk of PC for individuals with the non-O blood type, the previously reported protective allele (T) for rs505922 was found to be strongly correlated (r 2 = 0.96) with the O allele. In conclusion, this case-control study showed a statistically significant association between ABO blood group and PC risk in a Japanese population. Further studies are necessary to define the mechanisms by which the ABO gene or closely linked genetic variants influence PC risk. (Cancer Sci 2011; 102: 1076-1080 T he incidence of pancreatic cancer (PC) is increasing in Japan, and this cancer is now the sixth leading cause of cancer death.(1,2) Early detection of PC in its operable stage is difficult and curative treatment such as complete surgical removal is limited, which together give PC a 5-year relative survival rate of only 5.5%.(3) This suggests that epidemiological approaches to predicting the risk of PC may play an important role in identifying PC high-risk groups and ultimately decreasing the number of PC deaths.Risk factors for PC include advancing age, smoking, obesity, diabetes mellitus, family history of PC, alcohol consumption and chronic pancreatitis. (2,(4)(5)(6)(7)(8) Recently, a large prospective cohort study also showed a statistically significant association between ABO blood type and risk of PC.(9) Specifically, this study suggested that people with blood type O have a lower risk of PC than those with blood type A, B or AB. A genome-wide association study (GWAS) comparing PC cases and controls (PanScan), which includes the forementioned prospective cohort study population, (9) identified a single-nucleotide polymorphism (SNP) within the first intron of the ABO gene (rs505922) that was associated with PC risk.(10) Furthermore, using almost the same population as PanScan, Wolpin et al. (11) reported that the ABO blood type could be inferred from two SNPs (rs505922 and rs8176746), and concluded the relationship between PC risk a...