Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Abstract

Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce. We examined the association of cigarette smoking and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow‐up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% CI = 1.36–2.15), and risk increased with greater intensity and pack‐years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% CI = 1.23–2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% CI = 0.96–7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% CI = 1.00–2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.

Plasma carotenoids, vitamin C, retinol and tocopherols levels and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition: A nested case–control study

“…5 Active and moderately active according to the Cambridge Physical Activity Index incorporates occupational and nonoccupational physical activity. 6 Pill, hormone replacement therapy and estrogen replacement therapy. 7 Missing data of 60 cases and 61 controls.…”

“…2 Because pancreatic cancer is most often diagnosed at a late stage, prognosis is poor with 1-year survival rates of 20% and 5-year survival rates of only 4-5%. 2,3 Several risk factors have been consistently associated with the risk of developing pancreatic cancer, including family history of pancreatic cancer, 4 chronic pancreatitis, 5 cigarette smoking, 6 diabetes mellitus 7 and obesity. 8 According to the 2012 WCRF/AIRC expert report, evidence for the relation between vegetable and fruit consumption and pancreatic cancer risk is limited and inconsistent, 9 with inverse associations found in case-control studies and no associations found in cohort studies.…”

Active and Passive Smoking and the Risk of Pancreatic Cancer in the Netherlands Cohort Study

“…Most studies, including several cohort studies, a meta-analysis, and a pooled analysis of eight cohorts, indicated that current smokers had about a 2-fold increased pancreatic cancer risk compared with never smokers (2)(3)(4)(5)(6). Former smokers experience lower increased risks of pancreatic cancer as compared with current smokers, with risks ranging from 1.1 to 1.6 (2,(7)(8)(9)(10)(11). Pancreatic cancer risk increases with both number of cigarettes smoked daily (3,(5)(6)(7)(8)12) and duration of smoking (3,5,8,10,11).…”

“…Former smokers experience lower increased risks of pancreatic cancer as compared with current smokers, with risks ranging from 1.1 to 1.6 (2,(7)(8)(9)(10)(11). Pancreatic cancer risk increases with both number of cigarettes smoked daily (3,(5)(6)(7)(8)12) and duration of smoking (3,5,8,10,11). After quitting cigarette smoking, the risk decreases gradually within 10 to 15 years towards unity (5,8,12,13).…”

Involvement of water pipe smoking in the development of human pancreatic cancer

“…The water pipe smoker may, therefore, inhale the equivalent of 100 or more cigarettes. [8][9][10] Consequently, we firmly believe that WPS is an important risk factor in the development of several human cancers, especially pancreatic cancer according to the study of Vrieling et al 1 Meanwhile, we propose, to conduct an international epidemiological study, in collaboration with several national Cancer centers, regarding the risk factor of WPS in human pancreatic cancer as well as other human cancers.…”