Stolzenberg-Solomon Rachael, Jin David, Huang Wen-Yi, Brockman John
Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, United States.
Department of Chemistry, University of Missouri Research Reactor Center, Columbia, MO, United States.
Am J Epidemiol. 2025 May 7;194(5):1275-1284. doi: 10.1093/aje/kwae165.
Environmental exposures to elements such as cadmium might be contributing to the increasing incidence of pancreatic cancer. Few prospective studies have examined the association between trace elements and pancreatic ductal adenocarcinoma (PDAC). We conducted a nested case-control study in participants aged 55-74 years at baseline from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial cohort to examine the association between 12 trace elements measured in prediagnostic whole-blood samples and PDAC. From May 1998 through December 2014, 318 incident PDAC cases were identified during follow-up to 16.7 years. Of 636 control participants, 2 who were alive when each case patient was diagnosed were selected and matched by age (±5 years), sex, calendar date of blood sample collection (2-month blocks), and race and ethnic group. We used multivariable adjusted conditional logistic regression to calculate odds ratios (ORs) and 95% CIs. Cadmium and molybdenum were associated with PDAC (highest compared with lowest quintile: for cadmium, OR = 1.81 [95% CI, 01.12-2.95], P = .03 for trend; for molybdenum, OR = 0.50 [95% CI, 0.32-0.80], P = .02 for trend). The inverse molybdenum association was only observed among ever smokers (OR = 0.31 [95% CI, 0.17-0.58]; P = .003 for trend, P = .03 for interaction) with no association in never smokers. Lead, arsenic, and other trace elements were not associated with PDAC. Our results support that an increasing prediagnostic whole-blood level of cadmium is associated with increased PDAS risk, whereas that for molybdenum reduces PDAC risk.
接触镉等元素的环境暴露可能是导致胰腺癌发病率上升的原因之一。很少有前瞻性研究探讨微量元素与胰腺导管腺癌（PDAC）之间的关联。我们在前列腺、肺、结直肠癌和卵巢癌筛查试验队列中，对基线年龄在55 - 74岁的参与者进行了一项巢式病例对照研究，以检验在诊断前全血样本中测量的12种微量元素与PDAC之间的关联。从1998年5月到2014年12月，在长达16.7年的随访期间，共确诊了318例新发PDAC病例。在636名对照参与者中，选择了2名在每个病例患者被诊断时仍存活的个体，并按照年龄（±5岁）、性别、血样采集的日历日期（2个月区间）以及种族和族裔群体进行匹配。我们使用多变量调整后的条件逻辑回归来计算比值比（OR）和95%置信区间（CI）。镉和钼与PDAC有关（最高五分位数与最低五分位数相比：镉，OR = 1.81 [95% CI，1.12 - 2.95]，趋势P = 0.03；钼，OR = 0.50 [95% CI，0.32 - 0.80]，趋势P = 0.02）。钼的反向关联仅在曾经吸烟者中观察到（OR = 0.31 [95% CI，0.17 - 0.58]；趋势P = 0.003，交互作用P = 0.03），从不吸烟者中无关联。铅、砷和其他微量元素与PDAC无关。我们的结果支持，诊断前全血中镉水平升高与PDAS风险增加有关，而钼水平升高则降低PDAC风险。
