title: Exposure to environmental chemicals and heavy metals, and risk of pancreatic cancer.
abstract: OBJECTIVE
  Exposure to various chemicals and heavy metals has been associated with risk of different cancers; however, data on whether such exposures may increase the risk of pancreatic cancer (PC) are very limited and inconclusive. We examined PC risk with self-reported exposures to chemicals and heavy metals.
  
  
  METHODS
  The design was a clinic-based, case-control study of data collected from 2000 to 2014 at Mayo Clinic in Rochester, Minnesota, USA. Cases were rapidly ascertained patients diagnosed with pancreatic ductal adenocarcinoma (n = 2,092). Controls were cancer-free patients in primary care clinics (n = 2,353), frequency-matched to cases on age, race, sex, and state/region of residence. Cases and controls completed identical risk factor questionnaires, which included yes/no questions about regular exposure to pesticides, asbestos, benzene, chlorinated hydrocarbons, chromium, and nickel. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) comparing those who affirmed exposure to each of the chemicals/heavy metals to those who reported no regular exposure, adjusting for potential confounders.
  
  
  RESULTS
  Self-reported regular exposure to pesticides was associated with increased odds of PC (OR 1.21, 95% CI 1.02-1.44). Regular exposure to asbestos (OR 1.54, 95% CI 1.23-1.92), benzene (OR 1.70, 95% CI 1.23-2.35), and chlorinated hydrocarbons (OR 1.63, 95% CI 1.32-2.02) also was associated with higher odds of PC. Chromium and nickel exposures were not significantly associated with PC.
  
  
  CONCLUSIONS
  These findings add to the limited data suggesting that exposure to pesticides, asbestos, benzene, and chlorinated hydrocarbons may increase PC risk. They further support the importance of implementing strategies that reduce exposure to these substances.
authors: Division of Epidemiology, Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN, 55905, USA.
authors: Samuel O
authors: SO
authors: Antwi
authors: Department of Clinical and Translational Science, Mayo Clinic Graduate School, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Elizabeth C
authors: EC
authors: Eckert
authors: Division of Epidemiology, Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN, 55905, USA.
authors: Corinna V
authors: CV
authors: Sabaque
authors: Division of Epidemiology, Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN, 55905, USA.
authors: Emma R
authors: ER
authors: Leof
authors: Division of Biomedical Statistics and Informatics, Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Kieran M
authors: KM
authors: Hawthorne
authors: Division of Biomedical Statistics and Informatics, Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: William R
authors: WR
authors: Bamlet
authors: Division of Biomedical Statistics and Informatics, Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Kari G
authors: KG
authors: Chaffee
authors: Division of Biomedical Statistics and Informatics, Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors: Ann L
authors: AL
authors: Oberg
authors: Division of Epidemiology, Health Sciences Research, Mayo Clinic, 200 First Street SW, Charlton 6-243, Rochester, MN, 55905, USA. Petersen.Gloria@mayo.edu.
authors: Gloria M
authors: http://orcid.org/0000-0003-3424-7039
authors: GM
authors: Petersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000633:toxicity*; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000633:toxicity*; D015994:Incidence; D008297:Male; D019216:Metals, Heavy / Q000633:toxicity*; D008875:Middle Aged; D008910:Minnesota; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000209:etiology*; D010575:Pesticides / Q000633:toxicity*; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006843:Hydrocarbons, Chlorinated; D019216:Metals, Heavy; D010575:Pesticides; D001194:Asbestos
keywords: Asbestos; Benzene; Chlorinated hydrocarbons; Pancreatic cancer; Pesticides