Department of Gastrointestinal Medical Oncology, The Cancer and Hematology Centers, Grand Rapids, MI, USA.
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.
Eur J Cancer. 2024 Feb;198:113471. doi: 10.1016/j.ejca.2023.113471. Epub 2023 Dec 12.
Emerging cancer trends suggest an increase in pancreatic cancer incidence in individuals younger than its typical age of onset, potentially reflecting changes in population exposures and lifestyles.
We conducted a PRISMA-standard systematic literature review to identify non-heritable risk factors for early-onset pancreatic ductal adenocarcinoma (PDAC) (PROSPERO number: CRD42022299397). Systematic searches of MEDLINE and Embase bibliographic databases were performed (January 2022), and publications were screened against predetermined eligibility criteria; data were extracted using standardised data fields. The STROBE checklist was used to assess the completeness of reporting as a proxy for publication quality. Data were categorised by risk factor and analysed descriptively.
In total, 24 publications were included. All publications reported observational study data; thresholds for age group comparisons ranged between 40 and 65 years. Lifestyle factors investigated included smoking, alcohol consumption, obesity, physical inactivity, meat intake, socioeconomic status and geographical residence. Clinical factors investigated included pancreatitis, diabetes/insulin resistance, prior cancer and cancer stage at diagnosis, hepatitis B infection, metabolic syndrome and long-term proton pump inhibitor exposure. Publication STROBE scores were 6-21 (maximum, 22). Eight studies reported results adjusted for confounders. Potential non-heritable risk factors for early-onset PDAC that warrant further investigation included smoking, alcohol consumption, pancreatitis and hepatitis B infection.
Evidence for non-heritable risk factors for early-onset PDAC is heterogeneous, but four factors were identified that might aid the identification of at-risk individuals who may benefit from screening and risk reduction strategies.
新出现的癌症趋势表明，年轻人群中胰腺癌的发病率增加，这可能反映了人群暴露和生活方式的变化。
我们进行了 PRISMA 标准的系统文献综述，以确定早发性胰腺导管腺癌（PDAC）的非遗传性危险因素（PROSPERO 编号：CRD42022299397）。对 MEDLINE 和 Embase 书目数据库进行了系统搜索（2022 年 1 月），并根据预先确定的合格标准筛选出版物；使用标准化的数据字段提取数据。STROBE 清单用于评估报告的完整性，作为出版质量的代理。根据危险因素进行数据分类，并进行描述性分析。
共纳入 24 篇出版物。所有出版物均报告了观察性研究数据；年龄组比较的阈值范围在 40 岁至 65 岁之间。研究的生活方式因素包括吸烟、饮酒、肥胖、身体活动不足、肉类摄入、社会经济地位和地理居住。研究的临床因素包括胰腺炎、糖尿病/胰岛素抵抗、既往癌症和诊断时的癌症分期、乙型肝炎感染、代谢综合征和长期质子泵抑制剂暴露。出版物 STROBE 评分在 6 至 21 之间（最高 22 分）。有 8 项研究报告了调整混杂因素后的结果。需要进一步研究的早发性 PDAC 的潜在非遗传性危险因素包括吸烟、饮酒、胰腺炎和乙型肝炎感染。
早发性 PDAC 的非遗传性危险因素的证据存在异质性，但确定了四个可能有助于识别高危个体的因素，这些个体可能受益于筛查和降低风险的策略。
