Journal
ANNALS OF ONCOLOGY
Volume 23, Issue 11, Pages 2964-2970Publisher
OXFORD UNIV PRESS
DOI: 10.1093/annonc/mds140
Keywords
case-control studies; pancreatitis; pancreatic cancer; pooled analysis; risk factors
Categories
Funding
- National Cancer Institute (NCI)
- Prevention, Control and Population Research Goldstein Award
- society of MSKCC
- Geoffrey Beene Cancer Research Fund
- National Institutes of Health [5R01CA098870, CA59706, CA108370, CA109767, CA89726, CA121846]
- Stamford Hospital
- National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics
- Rombauer Pancreatic Cancer Research Fund
- California Department of Public Health
- National Cancer Institute's Surveillance, Epidemiology, and End Results Program [N01-PC-35136]
- Centers for Disease Control and Prevention's National Program of Cancer Registries [U55/CCR921930-02]
- Italian Association for Cancer Research (AIRC) [10068]
- Ministry of Health, Welfare, and Sports (formerly Ministry of Welfare, Health, and Culture) of the Netherlands
- Commission of the European Communities
- Fonds de recerche du Quebec - Sante (FRSQ)
- U.S. National Institutes of Health [CA98380]
- CD Smithers Foundation
- Spanish Ministry of Health [ISCIII RETICC RD06/0020]
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Pancreatitis is a known risk factor for pancreatic cancer; however, an unknown fraction of the disease is thought to be a consequence of tumor-related duct obstruction. A pooled analysis of a history of pancreatitis and risk of pancreatic cancer was carried out considering the time interval between diagnoses and potential modification by covariates. Adjusted pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from 10 case-control studies (5048 cases of ductal pancreatic adenocarcinoma and 10 947 controls) taking part in the International Pancreatic Cancer Case-Control Consortium (PanC4). The association between pancreatitis and pancreatic cancer was nearly three-fold at intervals of > 2 years between diagnoses (OR: 2.71, 95% CI: 1.96-3.74) and much stronger at intervals of < 2 years (OR: 13.56, 95% CI: 8.72-21.90) probably reflecting a combination of reverse causation and antecedent misdiagnosis of pancreas cancer as pancreatitis. The younger (< 65 years) pancreatic cancer cases showed stronger associations with previous (> 2 years) pancreatitis (OR: 3.91, 95% CI: 2.53-6.04) than the older (>= 65 years) cases (OR: 1.68, 95% CI: 1.02-2.76; P value for interaction: 0.006). Despite a moderately strong association between pancreatitis (diagnosed before > 2 years) and pancreatic cancer, the population attributable fraction was estimated at 1.34% (95% CI: 0.612-2.07%), suggesting that a relatively small proportion of pancreatic cancer might be avoided if pancreatitis could be prevented.
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