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.
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Alina
A
Vrieling
H Bas
HB
Bueno-de-Mesquita
Hendriek C
HC
Boshuizen
Dominique S
DS
Michaud
Marianne T
MT
Severinsen
Kim
K
Overvad
Anja
A
Olsen
Anne
A
Tjønneland
Françoise
F
Clavel-Chapelon
Marie-Christine
MC
Boutron-Ruault
Rudolf
R
Kaaks
Sabine
S
Rohrmann
Heiner
H
Boeing
Ute
U
Nöthlings
Antonia
A
Trichopoulou
Eftihia
E
Moutsiou
Vardis
V
Dilis
Domenico
D
Palli
Vittorio
V
Krogh
Salvatore
S
Panico
Rosario
R
Tumino
Paolo
P
Vineis
Carla H
CH
van Gils
Petra H M
PH
Peeters
Eiliv
E
Lund
Inger T
IT
Gram
Laudina
L
Rodríguez
Antonio
A
Agudo
Nerea
N
Larrañaga
María-José
MJ
Sánchez
Carmen
C
Navarro
Aurelio
A
Barricarte
Jonas
J
Manjer
Björn
B
Lindkvist
Malin
M
Sund
Weimin
W
Ye
Sheila
S
Bingham
Kay-Tee
KT
Khaw
Andrew
A
Roddam
Tim
T
Key
Paolo
P
Boffetta
Eric J
EJ
Duell
Mazda
M
Jenab
Valentina
V
Gallo
Elio
E
Riboli
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