Katzke Verena A, Dutta Srimanti, Rasokat Anna, Archibugi Livia, Capurso Gabriele, Peduzzi Giulia, Gentiluomo Manuel, Canzian Federico, Eriksen Anne Kirstine, Tjønneland Anne, Dahm Christina C, Truong Therese, Canonico Marianne, Laouali Nasser, Schulze Matthias B, Tumino Rosario, Masala Giovanna, Agnoli Claudia, Dansero Lucia, Panico Salvatore, Crous-Bou Marta, Molina-Montes Esther, Dorronsoro Ane, Chirlaque María-Dolores, Guevara Marcela, Butt Salma Tunå, Sund Malin, Christakoudi Sofia, Aglago Elom K, Weiderpass Elisabete, Gunter Marc, Campa Daniele, Kaaks Rudolf
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
Clinic I for Internal Medicine, University Clinic Cologne, 50937 Cologne, Germany.
Cancers (Basel). 2025 Jul 8;17(14):2275. doi: 10.3390/cancers17142275.
Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15-1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05-1.19) per 5 cm, 1.18 (1.02-1.36) per 100 g/d, 1.42 (1.27-1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61-0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53-0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect.
在全球范围内，男性患胰腺癌（PC）的发病率高于女性。为了更深入了解这种性别差异的潜在原因，我们在欧洲癌症与营养前瞻性调查（EPIC）队列中分析了PC的一般风险因素和性别相关风险因素（女性/男性数量=293,682/136,728；PC病例717/577）。Cox比例风险模型显示，在调整年龄、吸烟史、体重指数、糖尿病和饮酒量后，男性患PC的风险比女性高1.31倍（风险比，95%置信区间1.15-1.49）。PC与既定风险因素的关联在男性和女性之间没有差异，但在身高更高、肉类摄入量更大和吸烟量更多的女性中患PC的风险更高（每5厘米为1.12（1.05-1.19），每100克/天为1.18（1.02-1.36），每10支/天为1.42（1.27-1.59））。在育龄妇女中，母乳喂养的累积时间较长与PC风险呈负相关（相对于≤5.7个月，母乳喂养>5.7个月（中位数）时的风险比为0.74，95%置信区间0.61-0.89），在使用激素替代疗法（HRT）的女性中，HRT的累积使用时间与PC风险呈负相关（风险比为0.71，95%置信区间0.53-0.95，>2.4年与≤2.4年相比）。月经初潮年龄、足月妊娠次数、绝经年龄或口服避孕药的使用等其他生殖和激素因素与PC风险没有显著关联。需要对大型队列研究进行汇总分析以证实这些结果，并且需要关于HRT类型和强度的详细数据以更好地评估其效果。
