Cigarette smoking and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium.
Smoking is an established risk factor for pancreatic cancer; however, detailed examination of the association of smoking intensity, smoking duration, and cumulative smoking dose with pancreatic cancer is limited. The authors analyzed pooled data from the international Pancreatic Cancer Cohort Consortium nested case-control study (1,481 cases, 1,539 controls). Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Smoking intensity effects were examined with an excess odds ratio model that was linear in pack-years and exponential in cigarettes smoked per day and its square. When compared with never smokers, current smokers had a significantly elevated risk (odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.38, 2.26). Risk increased significantly with greater intensity (> or =30 cigarettes/day: OR = 1.75, 95% CI: 1.27, 2.42), duration (> or =50 years: OR = 2.13, 95% CI: 1.25, 3.62), and cumulative smoking dose (> or =40 pack-years: OR = 1.78, 95% CI: 1.35, 2.34). Risk more than 15 years after smoking cessation was similar to that for never smokers. Estimates of excess odds ratio per pack-year declined with increasing intensity, suggesting greater risk for total exposure delivered at lower intensity for longer duration than for higher intensity for shorter duration. This finding and the decline in risk after smoking cessation suggest that smoking has a late-stage effect on pancreatic carcinogenesis.
Lynch
Shannon M
SM
National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA. lynchs@mail.nih.gov
Vrieling
Alina
A
Lubin
Jay H
JH
Kraft
Peter
P
Mendelsohn
Julie B
JB
Hartge
Patricia
P
Canzian
Federico
F
Steplowski
Emily
E
Arslan
Alan A
AA
Gross
Myron
M
Helzlsouer
Kathy
K
Jacobs
Eric J
EJ
LaCroix
Andrea
A
Petersen
Gloria
G
Zheng
Wei
W
Albanes
Demetrius
D
Amundadottir
Laufey
L
Bingham
Sheila A
SA
Boffetta
Paolo
P
Boutron-Ruault
Marie-Christine
MC
Chanock
Stephen J
SJ
Clipp
Sandra
S
Hoover
Robert N
RN
Jacobs
Kevin
K
Johnson
Karen C
KC
Kooperberg
Charles
C
Luo
Juhua
J
Messina
Catherine
C
Palli
Domenico
D
Patel
Alpa V
AV
Riboli
Elio
E
Shu
Xiao-Ou
XO
Rodriguez Suarez
Laudina
L
Thomas
Gilles
G
Tjønneland
Anne
A
Tobias
Geoffrey S
GS
Tong
Elissa
E
Trichopoulos
Dimitrios
D
Virtamo
Jarmo
J
Ye
Weimin
W
Yu
Kai
K
Zeleniuch-Jacquette
Anne
A
Bueno-de-Mesquita
H Bas
HB
Stolzenberg-Solomon
Rachael Z
RZ
D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012306:Risk; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology