Serum insulin-like growth factor-I, insulin-like growth factor binding protein-3, and the risk of pancreatic cancer death

Recent epidemiological studies have shown that high serum levels of insulin-like growth factor-1 (IGF-1) are associated with an increased risk of lung, colon, breast and prostate cancer. Since very few studies have addressed the role of serum levels of IGF-1 in the development of pancreatic cancer, we conducted a nested case-control study to examine this association. The analysis involved 69 case subjects who died from pancreatic cancer during the follow-up period of the study, and 207 control subjects matched for sex, age(+/- 1 year) and study area, selected randomly from a cohort of 10,364 individuals. Serum levels of IGF-1 and IGF binding protein-3 (IGFBP-3) were measured by immunoradiometric assay, using commercially available kits. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic models. The levels of IGF-1 were positively correlated with IGFBP-3 (r = 0.55). There was a positive, but statistically insignificant association between serum levels of IGF-1 and risk of death from pancreatic cancer, with subjects in the highest quartile having an OR of 2.31 (95% CI = 0.70-2.64) compared to those in the lowest quartile. The risk of pancreatic cancer death increased significantly with increasing serum levels of IGFBP-3 (trend p = 0.03). Further adjustment for IGFBP-3 or IGF-1 slightly attenuated the positive associations. This nested case-control study showed that high serum levels of IGF-1 and IGFBP-3 may be associated with an increased risk of death from pancreatic cancer. (C) 2004 Wiley-Liss, Inc.