title: Pancreatitis and pancreatic cancer risk: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4).
abstract: BACKGROUND
  Pancreatitis is a known risk factor for pancreatic cancer; however, an unknown fraction of the disease is thought to be a consequence of tumor-related duct obstruction.
  
  
  METHODS
  A pooled analysis of a history of pancreatitis and risk of pancreatic cancer was carried out considering the time interval between diagnoses and potential modification by covariates. Adjusted pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from 10 case-control studies (5048 cases of ductal pancreatic adenocarcinoma and 10,947 controls) taking part in the International Pancreatic Cancer Case-Control Consortium (PanC4).
  
  
  RESULTS
  The association between pancreatitis and pancreatic cancer was nearly three-fold at intervals of >2 years between diagnoses (OR: 2.71, 95% CI: 1.96-3.74) and much stronger at intervals of ≤2 years (OR: 13.56, 95% CI: 8.72-21.90) probably reflecting a combination of reverse causation and antecedent misdiagnosis of pancreas cancer as pancreatitis. The younger (<65 years) pancreatic cancer cases showed stronger associations with previous (>2 years) pancreatitis (OR: 3.91, 95% CI: 2.53-6.04) than the older (≥65 years) cases (OR: 1.68, 95% CI: 1.02-2.76; P value for interaction: 0.006).
  
  
  CONCLUSIONS
  Despite a moderately strong association between pancreatitis (diagnosed before >2 years) and pancreatic cancer, the population attributable fraction was estimated at 1.34% (95% CI: 0.612-2.07%), suggesting that a relatively small proportion of pancreatic cancer might be avoided if pancreatitis could be prevented.
authors: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain. Electronic address: eduell@iconcologia.net.
authors: E J
authors: EJ
authors: Duell
authors: Department of Epidemiology, Institute for Pharmacological Research 'Mario Negri', Milan; Department of Preclinical and Clinical Pharmacology 'Mario Aiazzi Mancini', University of Florence, Florence, Italy.
authors: E
authors: E
authors: Lucenteforte
authors: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York.
authors: S H
authors: SH
authors: Olson
authors: Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco.
authors: P M
authors: PM
authors: Bracci
authors: Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston.
authors: D
authors: D
authors: Li
authors: Department of Epidemiology and Public Health, School of Public Health, School of Medicine, Yale University, New Haven.
authors: H A
authors: HA
authors: Risch
authors: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA.
authors: D T
authors: DT
authors: Silverman
authors: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA.
authors: B T
authors: BT
authors: Ji
authors: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: S
authors: S
authors: Gallinger
authors: Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco.
authors: E A
authors: EA
authors: Holly
authors: School of Public Health, Louisiana State University, New Orleans, USA.
authors: E H
authors: EH
authors: Fontham
authors: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors: P
authors: P
authors: Maisonneuve
authors: National Institute for Public Health and the Environment, Bilthoven; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
authors: H B
authors: HB
authors: Bueno-de-Mesquita
authors: Epidemiology Research Unit, Research Centre of the University of Montreal Hospital Centre (CRCHUM), Montreal, Canada.
authors: P
authors: P
authors: Ghadirian
authors: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York.
authors: R C
authors: RC
authors: Kurtz
authors: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York.
authors: E
authors: E
authors: Ludwig
authors: Department of Epidemiology and Public Health, School of Public Health, School of Medicine, Yale University, New Haven; Cancer Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu.
authors: H
authors: H
authors: Yu
authors: Department of Surgery, New York Medical College, Valhalla.
authors: A B
authors: AB
authors: Lowenfels
authors: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda.
authors: D
authors: D
authors: Seminara
authors: Departments of Health Science Research, Gastroenterology, and Medical Genetics, Mayo Clinic College of Medicine, Rochester, USA.
authors: G M
authors: GM
authors: Petersen
authors: Department of Epidemiology, Institute for Pharmacological Research 'Mario Negri', Milan; Department of Occupational Health, University of Milan, Milan, Italy.
authors: C
authors: C
authors: La Vecchia
authors: The Tisch Cancer Institute and Institute for Translational Epidemiology, Mt Sinai School of Medicine, New York, USA.
authors: P
authors: P
authors: Boffetta
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D016022:Case-Control Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D010195:Pancreatitis / Q000150:complications* / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects