Hart Andrew R, Kennedy Hugh, Harvey Ian
Population Health, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, Norfolk, United Kingdom.
Clin Gastroenterol Hepatol. 2008 Mar;6(3):275-82. doi: 10.1016/j.cgh.2007.12.041.
Pancreatic cancer kills more than 250,000 people each year worldwide and has a poor prognosis. The aim of this article is to critically review the epidemiologic evidence for exposures that may either increase or decrease the risk. A Medline search was performed for epidemiologic studies and reviews published up to April 2007. Consistent evidence of a positive association was found for family history and cigarette smoking. Many studies documented a positive association with diabetes mellitus and chronic pancreatitis, although the etiologic mechanisms are unclear. Other associations were detected, but the results were either inconsistent or from few studies. These included positive associations with red meat, sugar, fat, body mass index, gallstones, and Helicobacter pylori, and protective effects of increasing parity, dietary folate, aspirin, and statins. There was no evidence linking alcohol or coffee consumption with an increased risk of pancreatic cancer. The associations with many exposures need to be clarified from further epidemiologic work in which there is both precise measurement of risk factors, adjustment for potential confounders, and, for dietary studies, information recorded on the method of food preparation and pattern of consumption. Such work is important to reduce the incidence of this fatal disease.
胰腺癌每年在全球导致超过25万人死亡，且预后较差。本文旨在批判性地综述可能增加或降低风险的暴露因素的流行病学证据。对截至2007年4月发表的流行病学研究和综述进行了Medline检索。发现家族史和吸烟与胰腺癌呈正相关的证据一致。许多研究记录了糖尿病和慢性胰腺炎与胰腺癌呈正相关，尽管其病因机制尚不清楚。还检测到了其他关联，但结果要么不一致，要么来自少数研究。这些关联包括与红肉、糖、脂肪、体重指数、胆结石和幽门螺杆菌呈正相关，以及生育次数增加、膳食叶酸、阿司匹林和他汀类药物的保护作用。没有证据表明饮酒或喝咖啡会增加患胰腺癌的风险。许多暴露因素之间的关联需要通过进一步的流行病学研究来阐明，这些研究需要精确测量危险因素、对潜在混杂因素进行调整，对于饮食研究，还需要记录食物制备方法和消费模式的信息。此类研究对于降低这种致命疾病的发病率很重要。
