title: Plasma cotinine levels and pancreatic cancer in the EPIC cohort study.
abstract: Smoking is an established risk factor for pancreatic cancer, previously investigated by the means of questionnaires. Using cotinine as a biomarker for tobacco exposure allows more accurate quantitative analyses to be performed. This study on pancreatic cancer, nested within the European Prospective Investigation into Cancer and Nutrition (EPIC cohort), included 146 cases and 146 matched controls. Using liquid chromatography-mass spectrometry, plasma cotinine levels were analyzed on average 8.0 years before cancer onset (5-95% range: 2.8-12.0 years). The relation between plasma cotinine levels and pancreatic cancer was analyzed with conditional logistic regression for different levels of cotinine in a population of never and current smokers. This was also done for the self-reported number of smoked cigarettes per day at baseline. Every increase of 350 nmol/L of plasma cotinine was found to significantly elevate risk of pancreatic cancer [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.11-1.60]. People with a cotinine level over 1187.8 nmol/L, a level comparable to smoking 17 cigarettes per day, have an elevated risk of pancreatic cancer, compared to people with cotinine levels below 55 nmol/L (OR: 3.66, 95% CI: 1.44-9.26). The results for self-reported smoking at baseline also show an increased risk of pancreatic cancer from cigarette smoking based on questionnaire information. People who smoke more than 30 cigarettes per day showed the highest risk compared to never smokers (OR: 4.15, 95% CI: 1.02-16.42). This study is the first to show that plasma cotinine levels are strongly related to pancreatic cancer.
authors.affiliation: School of Public Health, Imperial College London, London, UK. m.leenders-6@umcutrecht.nl
authors.forename: Max
authors.initials: M
authors.lastname: Leenders
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Chuang
authors.forename: Christina C
authors.initials: CC
authors.lastname: Dahm
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Per Magne
authors.initials: PM
authors.lastname: Ueland
authors.forename: Oivind
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authors.lastname: Midttun
authors.forename: Stein Emil
authors.initials: SE
authors.lastname: Vollset
authors.forename: Anne
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authors.lastname: Tjønneland
authors.forename: Jytte
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authors.lastname: Halkjaer
authors.forename: Mazda
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authors.lastname: Jenab
authors.forename: Françoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Federico
authors.initials: F
authors.lastname: Canzian
authors.forename: Heiner
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authors.lastname: Boeing
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Androniki
authors.initials: A
authors.lastname: Naska
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Fränzel J B
authors.initials: FJ
authors.lastname: van Duijnhoven
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Carla H
authors.initials: CH
authors.lastname: van Gils
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodriguez
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Duell
authors.forename: María-José Sánchez
authors.initials: MJ
authors.lastname: Pérez
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: José María Huerta
authors.initials: JM
authors.lastname: Castaño
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Dorthe
authors.initials: D
authors.lastname: Johansen
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.forename: Malin
authors.initials: M
authors.lastname: Sund
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Dominique S
authors.initials: DS
authors.lastname: Michaud
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Wei W
authors.initials: WW
authors.lastname: Xun
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Francesca L
authors.initials: FL
authors.lastname: Crowe
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
mesh_terms: D016022:Case-Control Studies; D002853:Chromatography, Liquid; D015331:Cohort Studies; D003367:Cotinine / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D013058:Mass Spectrometry; D010190:Pancreatic Neoplasms / Q000097:blood*; D012907:Smoking / Q000097:blood*
chemical_list: D003367:Cotinine