Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition.
Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce. We examined the association of cigarette smoking and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% CI = 1.36-2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% CI = 1.23-2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% CI = 0.96-7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% CI = 1.00-2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.
Vrieling
Alina
A
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Bueno-de-Mesquita
H Bas
HB
Boshuizen
Hendriek C
HC
Michaud
Dominique S
DS
Severinsen
Marianne T
MT
Overvad
Kim
K
Olsen
Anja
A
Tjønneland
Anne
A
Clavel-Chapelon
Françoise
F
Boutron-Ruault
Marie-Christine
MC
Kaaks
Rudolf
R
Rohrmann
Sabine
S
Boeing
Heiner
H
Nöthlings
Ute
U
Trichopoulou
Antonia
A
Moutsiou
Eftihia
E
Dilis
Vardis
V
Palli
Domenico
D
Krogh
Vittorio
V
Panico
Salvatore
S
Tumino
Rosario
R
Vineis
Paolo
P
van Gils
Carla H
CH
Peeters
Petra H M
PH
Lund
Eiliv
E
Gram
Inger T
IT
Rodríguez
Laudina
L
Agudo
Antonio
A
Larrañaga
Nerea
N
Sánchez
María-José
MJ
Navarro
Carmen
C
Barricarte
Aurelio
A
Manjer
Jonas
J
Lindkvist
Björn
B
Sund
Malin
M
Ye
Weimin
W
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Roddam
Andrew
A
Key
Tim
T
Boffetta
Paolo
P
Duell
Eric J
EJ
Jenab
Mazda
M
Gallo
Valentina
V
Riboli
Elio
E
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution