Smoking and pancreatic cancer: a sex-specific analysis in the Multiethnic Cohort study

Gram, Inger Torhild; Park, Song-Yi; Wilkens, Lynne R.; Marchand, Loı̈c Le; Setiawan, Veronica Wendy

doi:10.1007/s10552-022-01637-z

Cited by 5 publications

(4 citation statements)

References 35 publications

(49 reference statements)

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“…20 Another group identified that current smoking was associated with risk of PC in a multiethnic cohort, a risk which increased with smoking duration and higher dosages. 21 The 2-year cumulative incidence of PC was 1.6% in our AP cohort, a risk over 23 times higher than that of the age-matched general population, based on results from Surveillance, Epidemi-ology, and End Results. 22 Despite the high mortality and morbidity from PC, screening all individuals in the general population for PC is not feasible given its rarity.…”

Section: Resultsmentioning

confidence: 76%

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A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With Acute Pancreatitis

Wang,

Rahimi Larki,

Dobkin

et al. 2024

Pancreas

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Objectives We aimed to develop and validate a prediction model as the first step in a sequential screening strategy to identify acute pancreatitis (AP) individuals at risk for pancreatic cancer (PC). Materials and Methods We performed a population-based retrospective cohort study among individuals 40 years or older with a hospitalization for AP in the US Veterans Health Administration. For variable selection, we used least absolute shrinkage and selection operator regression with 10-fold cross-validation to identify a parsimonious logistic regression model for predicting the outcome, PC diagnosed within 2 years after AP. We evaluated model discrimination and calibration. Results Among 51,613 eligible study patients with AP, 801 individuals were diagnosed with PC within 2 years. The final model (area under the receiver operating curve, 0.70; 95% confidence interval, 0.67–0.73) included histories of gallstones, pancreatic cyst, alcohol use, smoking, and levels of bilirubin, triglycerides, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, and albumin. If the predicted risk threshold was set at 2% over 2 years, 20.3% of the AP population would undergo definitive screening, identifying nearly 50% of PC associated with AP. Conclusions We developed a prediction model using widely available clinical factors to identify high-risk patients with PC-associated AP, the first step in a sequential screening strategy.

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Section: Resultsmentioning

confidence: 76%

“…Pancreatic cysts were previously found to be present in nearly 50% of high-risk surveillance groups who progressed to PC 20 . Another group identified that current smoking was associated with risk of PC in a multiethnic cohort, a risk which increased with smoking duration and higher dosages 21 …”

Section: Discussionmentioning

confidence: 99%

A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With Acute Pancreatitis

Wang,

Rahimi Larki,

Dobkin

et al. 2024

Pancreas

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“…These ndings are consistent to previous research. 33,34 Smoking is a known risk factor for PC as well as for disease progression in CP. 35 Furthermore, this study revealed that overweight, prediabetes or diabetes, gallstone disease, and hepatic brosis/cirrhosis were associated with an increased risk of PC among patients with pancreatitis, which is in line with a previous study.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk of pancreatic cancer in patients with acute or chronic pancreatitis: a population-based cohort study

Park

Kim

Han

et al. 2023

Preprint

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We aimed to evaluate the incidence and risk of PC in pancreatitis. We identified patients with acute pancreatitis (AP) (n = 225,811, 50.0%) and chronic pancreatitis (CP) (n = 225,685, 50.0%) from Korean population-based data and matched them with age- and sex-matched controls (n = 4,514,960). We analyzed the incidence and adjusted hazard ratios (aHRs) of PC among patients followed for more than 2 years or 5 years, and assessed risk changes over time in single episode of AP (SAP), recurrent AP (RAP), CP with AP, and CP without AP groups. We also performed subgroup analysis for both sexes. The incidences (per 104 person-years) and risks (aHR) of PC were higher in the RAP (12.69, 5.00) or CP with AP (12.12, 5.74) groups compared to the SAP (2.31, 1.32) or CP without AP (2.28, 1.57) groups. The risks of PC decreased over time, however, the risk of PC remained elevated in the RAP and CP with AP groups for more than 8 years. Females with RAP, SAP, and CP with AP had higher risks of PC than males. The risk of PC is higher and persists for longer duration in patients with RAP and CP with AP compared to those with SAP or CP without AP.

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“…Cigarette smoking: Most publications agree that cigarette smoking represents an important risk factor for PDAC [ 92 , 93 , 94 , 95 , 96 , 97 ]. According to Silverman et al [ 98 ], eliminating cigarette smoking would decrease pancreatic cancer incidence by 27% in the United States.…”

Section: Part 1: Pancreatic Cancer Riskmentioning

confidence: 99%

Earlier Diagnosis of Pancreatic Cancer: Is It Possible?

Koltai

2023

Cancers

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Pancreatic ductal adenocarcinoma has a very high mortality rate which has been only minimally improved in the last 30 years. This high mortality is closely related to late diagnosis, which is usually made when the tumor is large and has extensively infiltrated neighboring tissues or distant metastases are already present. This is a paradoxical situation for a tumor that requires nearly 15 years to develop since the first founding mutation. Response to chemotherapy under such late circumstances is poor, resistance is frequent, and prolongation of survival is almost negligible. Early surgery has been, and still is, the only approach with a slightly better outcome. Unfortunately, the relapse percentage after surgery is still very high. In fact, early surgery clearly requires early diagnosis. Despite all the advances in diagnostic methods, the available tools for improving these results are scarce. Serum tumor markers permit a late diagnosis, but their contribution to an improved therapeutic result is very limited. On the other hand, effective screening methods for high-risk populations have not been fully developed as yet. This paper discusses the difficulties of early diagnosis, evaluates whether the available diagnostic tools are adequate, and proposes some simple and not-so-simple measures to improve it.

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Smoking and pancreatic cancer: a sex-specific analysis in the Multiethnic Cohort study

Cited by 5 publications

References 35 publications

A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With Acute Pancreatitis

A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With Acute Pancreatitis

Incidence and risk of pancreatic cancer in patients with acute or chronic pancreatitis: a population-based cohort study

Earlier Diagnosis of Pancreatic Cancer: Is It Possible?

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