1] School for Oncology and Developmental Biology (GROW), Department of Epidemiology, Maastricht University Medical Centre+, Peter Debyeplein 1, 6229 HA, Maastricht, The Netherlands [2] Department of Biochemistry, Maastricht University Medical Centre+, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands.
Br J Cancer. 2013 Nov 26;109(11):2924-32. doi: 10.1038/bjc.2013.629. Epub 2013 Oct 22.
To date, only a few risk factors for pancreatic cancer have been established. We examined prospectively relations between several medical conditions and pancreatic cancer incidence.
In 1986, 120 852 participants completed a baseline questionnaire on cancer risk factors, including several self-reported physician diagnosed medical conditions. At baseline, a random subcohort of 5000 participants was selected using a case-cohort approach for analysis. After 16.3 years of follow-up, 448 pancreatic cancer cases (63% microscopically confirmed) were available for analysis.
Diabetes mellitus type II and hepatitis were positively associated with pancreatic cancer risk (multivariable-adjusted hazard ratio: 1.79; 95% confidence interval: 1.12-2.87 and hazard ratio: 1.37; 95% confidence interval: 1.04-1.81, respectively). Furthermore, a positive trend in risk with increasing years of diagnosis of diabetes (P=0.004) and of hepatitis (P=0.02) was observed. However, an inverse association was observed between hypertension and pancreatic cancer risk, this was found among microscopically confirmed cases only (hazard ratio: 0.66; 95% confidence interval: 0.49-0.90), while years since diagnosis of hypertension significantly decreased cancer risk (P for trend=0.02).
In this prospective study, a positive association was observed between self-reported physician diagnosed diabetes mellitus type II and hepatitis and pancreatic cancer risk, whereas an inverse association was observed with hypertension.
迄今为止,仅有少数胰腺癌的危险因素被确定。我们前瞻性地研究了几种医学状况与胰腺癌发病之间的关系。
1986 年,120852 名参与者完成了癌症危险因素的基线问卷,包括几项自我报告的医生诊断的医学状况。在基线时,采用病例-队列分析方法随机选择了 5000 名参与者的子队列进行分析。随访 16.3 年后,有 448 例胰腺癌病例(63%经显微镜证实)可用于分析。
2 型糖尿病和肝炎与胰腺癌风险呈正相关(多变量调整的危险比:1.79;95%置信区间:1.12-2.87 和危险比:1.37;95%置信区间:1.04-1.81)。此外,还观察到糖尿病(P=0.004)和肝炎(P=0.02)诊断年数与风险呈正相关趋势。然而,仅在显微镜确诊病例中观察到高血压与胰腺癌风险呈负相关(危险比:0.66;95%置信区间:0.49-0.90),而高血压诊断后年数显著降低了癌症风险(趋势 P 值=0.02)。
在这项前瞻性研究中,自我报告的医生诊断的 2 型糖尿病和肝炎与胰腺癌风险呈正相关,而高血压与胰腺癌风险呈负相关。