title: Risk Factors for Early-Onset and Very-Early-Onset Pancreatic Adenocarcinoma: A Pancreatic Cancer Case-Control Consortium (PanC4) Analysis.
abstract: OBJECTIVE
  While pancreatic cancer (PC) most often affects older adults, to date, there has been no comprehensive assessment of risk factors among PC patients younger than 60 years.
  
  
  METHODS
  We defined early-onset PC (EOPC) and very-early-onset PC (VEOPC) as diagnosis of PC in patients younger than 60 and 45 years, respectively. We pooled data from 8 case-control studies, including 1954 patients with EOPC and 3278 age- and sex-matched control subjects. Logistic regression analysis was performed to identify associations with EOPC and VEOPC.
  
  
  RESULTS
  Family history of PC, diabetes mellitus, smoking, obesity, and pancreatitis were associated with EOPC. Alcohol use equal to or greater than 26 g daily also was associated with increased risk of EOPC (odds ratio, 1.49; 95% confidence interval, 1.21-1.84), and there appeared to be a dose- and age-dependent effect of alcohol on risk. The point estimate for risk of VEOPC was an odds ratio of 2.18 (95% confidence interval, 1.17-4.09).
  
  
  CONCLUSIONS
  The established risk factors for PC, including smoking, diabetes, family history of PC, and obesity, also apply to EOPC. Alcohol intake appeared to have an age-dependent effect; the strongest association was with VEOPC.
authors.affiliation: From the *Department of Oncology, Mayo Clinic, Rochester, MN; †Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; ‡Division of Biostatistics, Mayo Clinic; §Department of Health Sciences Research, Mayo Clinic, Rochester, MN; ∥Department of Gastrointestinal Medical Oncology, UT MD Anderson Cancer Center, Houston, TX; ¶Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT; #Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; **Louisiana State University School of Public Health, New Orleans, LA; ††Tulane School of Public Health, New Orleans, LA; ‡‡Department of Epidemiology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," and §§Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; ∥∥S.O.C. Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, IRCCS, Aviano (PN), Italy; ¶¶National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom; ##Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; ***Division of General Surgery, University of Toronto, Toronto, Ontario, Canada; †††Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; and ‡‡‡Department of Surgery, Department of Family Medicine, New York Medical College, Valhalla, NY.
authors.forename: Robert R
authors.initials: RR
authors.lastname: McWilliams
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: William R
authors.initials: WR
authors.lastname: Bamlet
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Petersen
authors.forename: Donghui
authors.initials: D
authors.lastname: Li
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Risch
authors.forename: Herbert
authors.initials: H
authors.lastname: Yu
authors.forename: Elizabeth T H
authors.initials: ET
authors.lastname: Fontham
authors.forename: Brian
authors.initials: B
authors.lastname: Luckett
authors.forename: Cristina
authors.initials: C
authors.lastname: Bosetti
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno de Mesquita
authors.forename: Paige
authors.initials: P
authors.lastname: Bracci
authors.forename: Steven
authors.initials: S
authors.lastname: Gallinger
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
authors.forename: Albert B
authors.initials: AB
authors.lastname: Lowenfels
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D000367:Age Factors; D017668:Age of Onset; D000428:Alcohol Drinking / Q000009:adverse effects; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010195:Pancreatitis / Q000150:complications; D018570:Risk Assessment / Q000379:methods* / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects