Araghi Marzieh, Rosaria Galanti Maria, Lundberg Michael, Lager Anton, Engström Gunnar, Alfredsson Lars, Knutsson Anders, Norberg Margareta, Sund Malin, Wennberg Patrik, Trolle Lagerros Ylva, Bellocco Rino, Pedersen Nancy L, Östergren Per-Olof, Magnusson Cecilia
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm County Council, Sweden.
Int J Cancer. 2017 Aug 15;141(4):687-693. doi: 10.1002/ijc.30773. Epub 2017 May 19.
While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.
虽然吸烟是胰腺癌公认的危险因素，但无烟烟草的影响尚不太清楚。我们使用来自瑞典鼻烟使用健康影响合作项目的汇总个体数据，评估瑞典鼻烟使用与胰腺癌风险之间的关联。通过与健康登记册建立联系，对来自9项队列研究的总共424,152名男性参与者进行随访，以了解胰腺癌风险。我们使用在研究层面具有随机效应的共享脆弱模型，来估计调整混杂因素后的风险比（HR）和95%置信区间（CI）。在9,276,054人年的观察期内，有1,447名男性患胰腺癌。在调整吸烟因素后，与从不使用鼻烟相比，当前使用鼻烟与胰腺癌风险无关（HR 0.96，95% CI 0.83 - 1.11）。瑞典鼻烟使用似乎与男性胰腺癌的发生无关。除尼古丁或其代谢物之外的烟草烟雾成分可能是吸烟与胰腺癌之间关系的原因。
