title: Risk factors associated with earlier age of onset in familial pancreatic carcinoma.
abstract: BACKGROUND
  An estimated 5-10% of all pancreatic adenocarcinomas have a hereditary association. The objective of the current study was to characterize the clinical and pathologic features of familial pancreatic carcinoma and to determine potential differences in demographics, risk factors, and outcomes between familial and sporadic pancreatic carcinoma populations.
  
  
  METHODS
  A retrospective review was performed to identify patients diagnosed with pancreatic carcinoma who had an associated familial disposition. Demographic analyses and assessment of clinical features and treatment outcomes were performed for the familial subgroup, and the results were compared with observations made in the nonfamilial, or 'sporadic', population.
  
  
  RESULTS
  Thirty of 826 patients (3.6%) had familial pancreatic carcinoma. Baseline demographics, resectability, and metastases were similar in both the familial cohort and the sporadic cohort. The mean age of onset was slightly lower in the familial cohort (57.6 years, compared with 61 years in the sporadic cohort). However, the familial population had a significantly greater proportion of patients who were diagnosed at age <50 years compared with the sporadic population (36.7% vs. 18.3%; P=0.017). A positive smoking history was more commonly associated with familial pancreatic carcinoma (87% vs. 66%; P=0.06). The overall median survival durations were 7 months and 6 months for the familial group and the sporadic group, respectively.
  
  
  CONCLUSIONS
  Patients with familial pancreatic carcinoma present at an earlier age compared with their counterparts who have nonfamilial disease. Smoking may play a significant role in the risk or promotion of pancreatic carcinoma in patients with an inherited predisposition.
authors.affiliation: Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: Ted A
authors.initials: TA
authors.lastname: James
authors.forename: David G
authors.initials: DG
authors.lastname: Sheldon
authors.forename: Ashwani
authors.initials: A
authors.lastname: Rajput
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kuvshinoff
authors.forename: Milind M
authors.initials: MM
authors.lastname: Javle
authors.forename: Hector R
authors.initials: HR
authors.lastname: Nava
authors.forename: Judy L
authors.initials: JL
authors.lastname: Smith
authors.forename: John F
authors.initials: JF
authors.lastname: Gibbs
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D000328:Adult; D017668:Age of Onset; D015331:Cohort Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking