终生酒精摄入量与胰腺癌发病率及生存率:墨尔本协作队列研究的结果
Lifetime alcohol intake and pancreatic cancer incidence and survival: findings from the Melbourne Collaborative Cohort Study.
作者信息
Jayasekara Harindra, English Dallas R, Hodge Allison M, Room Robin, Hopper John L, Milne Roger L, Giles Graham G, MacInnis Robert J
机构信息
Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.
Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
出版信息
Cancer Causes Control. 2019 Apr;30(4):323-331. doi: 10.1007/s10552-019-01146-6. Epub 2019 Feb 23.
PURPOSE
Pancreatic cancer has one of the worst prognoses with 5-year survival below 10%. There is some evidence that alcohol consumption might increase the risk of pancreatic cancer. We examined associations of pre-diagnostic alcohol intake with (i) incidence of pancreatic cancer, and (ii) overall survival following pancreatic cancer.
METHODS
Usual alcohol intake was estimated at recruitment in 1990-1994 for 38,472 participants in the Melbourne Collaborative Cohort Study using recalled frequency and quantity of beverage-specific intake for 10-year periods from age 20. Pancreatic cancer incidence (C25 according to International Classification of Diseases for Oncology) and vital status were ascertained through to 30 September 2015. Cox regression was performed to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with lifetime, age 20-29, and baseline alcohol intakes.
RESULTS
By the end of follow-up (average 20.2 years), 239 incident cases of pancreatic cancer were diagnosed, of which 228 had died. No evidence of an association was observed between alcohol intake and risk of pancreatic cancer. Higher lifetime alcohol intake was associated with lower overall survival following a diagnosis of pancreatic cancer (mortality HR 1.09 per 10 g/day increment, 95% CI 1.00-1.19; p value = 0.04). A similar finding was observed for age 20-29 intake (HR 1.09 per 10 g/day increment, 95% CI 1.02-1.18; p value = 0.01) but not with baseline intake.
CONCLUSIONS
We observed an association between lower alcohol use from an early age and improved survival following pancreatic cancer, but this finding needs to be confirmed by other studies.
目的
胰腺癌的预后极差,5年生存率低于10%。有证据表明饮酒可能会增加患胰腺癌的风险。我们研究了诊断前酒精摄入量与(i)胰腺癌发病率,以及(ii)胰腺癌患者总生存期之间的关联。
方法
在1990 - 1994年招募时,对墨尔本协作队列研究中的38472名参与者,根据20岁起10年期间回忆的特定饮料摄入频率和数量,估算其通常的酒精摄入量。通过至2015年9月30日确定胰腺癌发病率(根据国际肿瘤疾病分类为C25)和生命状态。采用Cox回归分析,估计与终生、20 - 29岁及基线酒精摄入量相关的多变量调整风险比(HR)和95%置信区间(CI)。
结果
随访结束时(平均20.2年),确诊239例胰腺癌病例,其中228例死亡。未观察到酒精摄入量与胰腺癌风险之间存在关联的证据。终生酒精摄入量较高与胰腺癌诊断后的总生存期较低相关(每增加10克/天,死亡HR为1.09,95%CI为1.00 - 1.19;p值 = 0.04)。20 - 29岁摄入量也有类似发现(每增加10克/天,HR为1.09,95%CI为1.02 - 1.18;p值 = 0.01),但基线摄入量无此关联。
结论
我们观察到早年较低的酒精摄入量与胰腺癌患者生存期改善之间存在关联,但这一发现需要其他研究予以证实。