title: Smoking and other risk factors for pancreatic cancer: a cohort study in men in Lithuania.
abstract: BACKGROUND
  Cancer of the pancreas is a relatively rare, but highly fatal cancer worldwide. Cigarette smoking has been recognized as an important risk factor, but the relation to other potential determinants is still inconsistent. We investigated the association between different lifestyle, biological and anthropometric factors and the risk of pancreatic cancer in a prospective population-based cohort study from Kaunas, Lithuania.
  
  
  METHODS
  Our study included 7132 urban men initially free from any diagnosed cancer, followed for up to 30 years. 77 incident cases of pancreatic cancer were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI).
  
  
  RESULTS
  Compared to never smokers, current smokers had a significantly increased risk of pancreatic cancer, HR was 1.79 (95% CI 1.03-3.09) after adjustment for age, body mass index, education and alcohol consumption. Among smokers, a significant association with higher smoking intensity was shown (≥ 20 cigarettes/day: HR = 2.60; 95% CI 1.42-4.76, P(trend) = 0.046). We also observed a significantly increased risk for ≥ 30 pack-years of smoking (HR = 2.24; 95% CI 1.12-4.49, P(trend) = 0.16) and for age at starting smoking < 18 years (HR = 2.29; 95% CI 1.11-4.70, P(trend) = 0.43) as compared to never smokers. Alcohol consumption, body mass index and total cholesterol level were not significantly associated with pancreatic cancer.
  
  
  CONCLUSIONS
  Smoking significantly increases pancreatic cancer incidence and its high prevalence in Lithuania may partly explain high incidence of the disease. No convincing evidence was found that alcohol consumption, body mass index or serum cholesterol level were associated with pancreatic cancer risk, although the assessment was limited by the lack of statistical power.
authors.affiliation: Group of Epidemiology, Cancer Control and Prevention Center, Institute of Oncology, Vilnius University, P. Baublio 3B, LT-08406 Vilnius, Lithuania. irena.kuzmickiene@vuoi.lt
authors.forename: Irena
authors.initials: I
authors.lastname: Kuzmickiene
authors.forename: Ruta
authors.initials: R
authors.lastname: Everatt
authors.forename: Dalia
authors.initials: D
authors.lastname: Virviciute
authors.forename: Abdonas
authors.initials: A
authors.lastname: Tamosiunas
authors.forename: Ricardas
authors.initials: R
authors.lastname: Radisauskas
authors.forename: Regina
authors.initials: R
authors.lastname: Reklaitiene
authors.forename: Egle
authors.initials: E
authors.lastname: Milinaviciene
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008019:Life Style; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
chemical_list: D002784:Cholesterol