Lifestyle, dietary, and medical history factors associated with pancreatic cancer risk in Ontario, Canada

Abstract

Objectives Pancreatic adenocarcinoma has one of the worst survival rates of all the cancers. Established risk factors for this malignancy are smoking, body mass index (BMI) and family history of pancreatic cancer. Findings are inconsistent regarding pancreatitis, diabetes, allergies, intake of fruit, vegetables, red meat, alcohol, caffeine, vitamin C, calcium, and folate supplements. Possible pancreatic cancer risk factors were evaluated within the population-based Ontario Pancreas Cancer Study. Methods Pathologically confirmed pancreatic cancer cases (n = 422) were identified from the Ontario Cancer Registry between 2003 and 2007. Controls (n = 312) were recruited through random digit dialing. Data were collected using self-administered questionnaires. Multivariate logistic regression was used to obtain odds ratios. Results Smoking, BMI, family history of pancreatic cancer, and caffeine were significantly associated with increased pancreatic cancer risk, while fruit intake and allergies significantly decreased risk. No other significant associations were observed in the multivariate model. Effect modification by smoking status was suggested for caffeine, family history of pancreatic cancer, BMI, and fruit. Conclusions This study further clarifies the association between several lifestyle, dietary and medical history factors, and pancreatic cancer risk, many of which are potentially modifiable. Possible effect modification by smoking status should be further explored in future etiologic studies.

Diabetes mellitus, other medical conditions and pancreatic cancer: a case‐control study

“…Inverse associations have been reported between allergies and pancreatic cancer in a number of studies [12,[39][40][41], with a pooled OR of 0.82 (95% CI = 0.68-0.99) in a recent meta-analysis [39]. A protective effect of allergy on pancreatic cancer risk is speculated to be due to the hyperactivity of the immune system of allergic individuals [39,40].…”

Intake of Fruits and Vegetables and Risk of Pancreatic Cancer in a Pooled Analysis of 14 Cohort Studies

“…However, many of these studies included proxy respondents, thus increasing the likelihood that information bias may have affected results. Of the case-control studies that did not include proxies (10,12,53,(56)(57)(58)(59)61), inverse associations with fruit and/or vegetable intake were reported by most, but not all (10,57,59), with risk reductions ranging from 40% to 46% (10,12,53,56,58) for the highest fruit intakes versus the lowest and from 33% to 53% for the highest vegetable intakes versus the lowest (12,53,56,59,61). However, bias due to differential diet recall or differential participation rates related to fruit and vegetable consumption between cases and controls is possible in these studies.…”

“…The risk of pancreatic cancer in relation to fruit and vegetable consumption has been examined in over 35 epidemiologic studies (4,(7)(8)(9)(10)(11)(12)(13), and most have found inverse associations with fruit and/or vegetable intake. However, associations have been stronger in case-control studies than in cohort studies, and most case-control studies have relied on proxy respondents for exposure information, with proportions of proxies exceeding 50% of the case series in many studies (14)(15)(16)(17)(18)(19)(20)(21).…”

Familial pancreatic cancer and hereditary syndromes: screening strategy for high-risk individuals

“…A family history of PC is another risk factor [7][8][9][10][11][12][13][14][15][16]. Familial PC (FPC), which is defined as the presence of two first-degree relatives (FDRs) with PC and is not associated with known hereditary syndromes, accounts for 4-10% of all PC cases [7] (similar incidences in western countries and Japan [17]) ( Table 1) [17][18][19][20][21][22][23][24][25][26][27][28]. Some inherited syndromes also show higher risks, such as Peutz-Jeghers syndrome (PJS) [29], hereditary pancreatitis [30], familial atypical multiple mole melanoma (FAMMM), and hereditary breast-ovarian cancer (HBOC) [11] (Table 2).…”

“…Since the 1990s, the risk of a family history of PC has been assessed by case-control and cohort studies in many countries (Table 1) [17][18][19][20][21][22][23][24][25][26][27][28]. In case-control studies, the incidence of FPC among all cases of PC was 4-10% (5 [23]-7% [17] in Japan), and the odds ratio (OR) or relative risk (RR) for PC incurred by having a firstdegree relative (FDR) with PC was 2.09 [23]-5.25 [18].…”