Department of Epidemiology, Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Cancer Epidemiol Biomarkers Prev. 2010 Jun;19(6):1612-22. doi: 10.1158/1055-9965.EPI-10-0121. Epub 2010 May 25.
To date, cigarette smoking is the most consistent risk factor for pancreatic cancer. We prospectively examined the role of active cigarette smoking, smoking cessation, and passive smoking as determinants for pancreatic cancer.
The Netherlands Cohort Study consisted of 120,852 men and women who completed a baseline questionnaire in 1986. After 16.3 years of follow-up, 520 incident pancreatic cancer cases were available for analysis. A case-cohort approach was employed using the person-years of follow-up of a random subcohort (n = 5,000), which was chosen immediately after baseline.
Compared with never cigarette smokers, both former and current cigarette smokers had an increased pancreatic cancer risk [multivariable-adjusted hazard rate ratio (HR), 1.34; 95% confidence interval (CI), 1.02-1.75 and HR, 1.82; 95% CI, 1.40-2.38, respectively]. We observed an increased pancreatic cancer risk per increment of 10 years of smoking (HR, 1.15; 95% CI, 1.08-1.22) and an HR of 1.08 per increment of 10 cigarettes/d (95% CI, 0.98-1.19). Quitting smoking gradually reduced pancreatic cancer risk and approached unity after > or = 20 years of quitting. No association was observed for passive smoking exposure and pancreatic cancer risk in women; in men, this association was not investigated because >90% of the men were ever smokers.
Overall, our findings confirmed that cigarette smoking is an important risk factor for pancreatic cancer, whereas quitting smoking reduced risk. No association was observed between passive smoking exposure and pancreatic cancer risk in women.
Quitting smoking would benefit the burden on pancreatic cancer incidence.
迄今为止，吸烟是胰腺癌最一致的危险因素。我们前瞻性地研究了主动吸烟、戒烟和被动吸烟作为胰腺癌决定因素的作用。
荷兰队列研究包括 120852 名男性和女性，他们在 1986 年完成了基线问卷调查。经过 16.3 年的随访，有 520 例胰腺癌新发病例可供分析。采用病例-队列研究方法，使用基线后立即选择的随机亚队列（n=5000）的人年随访。
与从不吸烟的人相比，曾经吸烟者和当前吸烟者的胰腺癌风险均增加[多变量调整后的危险比（HR），1.34；95%置信区间（CI），1.02-1.75 和 HR，1.82；95%CI，1.40-2.38]。我们观察到吸烟量每增加 10 年（HR，1.15；95%CI，1.08-1.22）和每天增加 10 支香烟（HR，1.08；95%CI，0.98-1.19），胰腺癌风险都会增加。戒烟后胰腺癌风险逐渐降低，戒烟>或=20 年后风险接近 1.0。在女性中，没有观察到被动吸烟与胰腺癌风险之间的关联；在男性中，由于>90%的男性曾经吸烟，因此没有调查这种关联。
总的来说，我们的研究结果证实吸烟是胰腺癌的一个重要危险因素，而戒烟可降低风险。在女性中，没有观察到被动吸烟与胰腺癌风险之间的关联。
戒烟将有助于降低胰腺癌发病率的负担。
