Early precursors of pancreatic cancer in college men

doi:10.1016/0021-9681(83)90059-0

Journal of Chronic Diseases

Volume 36, Issue 3, 1983, Pages 251-256

Journal of Chronic D...

https://doi.org/10.1016/0021-9681(83)90059-0 Get rights and content

Abstract

From college data on 50,000 male former students, the records of 126 men who died of pancreatic cancer in a 16–50yr follow-up period were compared with those of 504 surviving classmates with respect to physical and social characteristics. Return mail questionnaires received from 30,000 surviving alumni in 1962 or 1966 also were reviewed for characteristics that might predict altered risk of pancreatic cancer. Strong positive associations were found for cigarette smoking as reported both during college (p < 0.001) and at time of questionnaire return (p = 0.03). Smoking 10 or more cigarettes per day during college corresponded to a relative risk of 2.6 with 95% confidence limits 1.5 to 4.6, and a positive smoking history at questionnaire return yielded a relative risk of 2.4 (1.1–5.1). No association was found for collegiate coffee drinking, either before or after adjustment for cigarette smoking. The relative risk for coffee drinking adjusted for smoking was 1.1 (0.7–1.8). In contrast, collegiate tea consumption was associated with a reduction in pancreatic cancer risk. The relative risk for tea drinking adjusted for smoking was 0.5 (0.3–0.9). Men who at college physical examination complained of occasional abdominal pain or discomfort had increased relative risk of pancreatic cancer (3.1 ; 1.1–9.0) in the follow-up period.

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2014, European Journal of Cancer
Question remains about the shape of the dose–response relationship between cigarette smoking and pancreatic cancer risk.
Relevant studies were identified by searching PubMed, ISI Web of Science and China National Knowledge Infrastructure (CNKI) databases and by reviewing the reference lists of retrieved articles. Random-effects models were applied to estimate summary relative risks (RRs).
Forty-two publications were finally included. The overall meta-analysis showed evidence of non-linear association between smoking intensity and pancreatic cancer risk (P for non-linearity = 0.000). Compared with non-smokers, the summary RRs were 1.5 (95% confidence interval (CI): 1.4, 1.6) for 10 cigarettes/day, 1.9 (95% CI: 1.8, 2.0) for 20 cigarettes/day, 2.0 (95% CI: 1.9, 2.1) for 30 cigarettes/day and 2.1 (95% CI: 1.9, 2.3) for 40 cigarettes/day with marginal between-study heterogeneity (I² = 29%). Similar results were also found for smoking duration and cumulative amount of cigarettes smoked. Besides, the summary RR for former smokers reduced with increasing time since quitting smoking compared with current smokers without heterogeneity (P for non-linearity = 0.008, I² = 0%). The results of stratified analysis by study design were comparable to those of overall meta-analysis. When stratified by sex, non-linear dose–response associations were detected for all metrics of cigarette smoking in women, while linear relationships were observed for smoking duration and cumulative amount of cigarettes smoked in men except for smoking intensity.
This meta-analysis reveals a non-linear dose–response association between cigarette smoking and pancreatic cancer risk, but it might differ between sexes.
Green tea drinking and risk of pancreatic cancer: A large-scale, population-based case-control study in urban Shanghai
2012, Cancer Epidemiology
Citation Excerpt :
In cohort studies, Shibata et al. accumulated 65 incident cases after 9 years follow-up of 13 979 residents of a retirement community in US [6]; Harnack et al. reported 66 incident cases of pancreatic cancer after 8 years of follow-up of 33 976 postmenopausal women in the Iowa Women's Health Study [9]; Luo et al. documented 233 incident cases after 11 years of follow-up of 102 137 Japanese individuals [11]; Lin et al. found 292 pancreatic cancer deaths after 13 years of follow-up of 110 792 subjects in another study in Japan [10]. While in case–control studies, Ji et al. recruited 451 pancreatic cases in Shanghai [5]; Whittemore et al. recorded 126 pancreatic cancer deaths out of 50 000 male former students [7]; Mack et al. recruited 490 pancreas cancer patients from Los Angeles County residents [12]; Zatonski et al. recruited 110 cases of pancreatic cancer cases in Poland [8]; and Kinlen and McPherson had 216 cases of pancreas cancer eligible for study [13]. Our study is the largest population-based case–control study to-date, to our knowledge, to examine the association between tea drinking habits and pancreatic cancer risk.
Background: Little is known about the etiology of pancreatic cancer. Epidemiological studies on tea consumption and pancreatic cancer risk have been inconclusive. The purpose of the present study was to investigate the association between green tea drinking and the risk of pancreatic cancer in urban Shanghai, China. Methods: In this population-based case–control study conducted in urban Shanghai, 908 cases of pancreatic cancer and 1067 healthy controls were recruited. Information on tea drinking, including type of tea, amount of tea consumption, temperature of tea, and the duration of regular tea drinking, were collected via interview questionnaire. Results: We examined the association of multiple tea drinking habits with the risk of pancreatic cancer. In women, regular green tea drinking was associated with 32% reduction of pancreatic cancer risk (OR 0.68, 95% CI 0.48–0.96), compared to those who did not drink tea regularly. Increased consumption and longer duration of tea drinking were both associated with reduced pancreatic cancer risk in women. Among regular tea drinkers, lower temperature of tea was associated with reduced risk of pancreatic cancer in both men and women, independent of amount or duration of tea drinking. Conclusions: Habits of green tea drinking, including regular drinking, amount of consumption, persistence of the habit, and tea temperature, may lower pancreatic cancer risk.
The burning question: Why is smoking a risk factor for pancreatic cancer?
2012, Pancreatology
Citation Excerpt :
Strong positive associations were found for cigarette smoking. Smoking 10 or more cigarettes per day during college corresponded to a relative risk of 2.6, and an otherwise positive smoking history yielded a relative risk of 2.4 [46]. The meta-analysis by Iodice et al, of 82 published studies containing epidemiologic information about smoking and pancreatic cancer showed a slightly lower overall risk of 1.74 in current smokers [47].
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease. The prognosis is poor; less than 5% of those diagnosed are still alive five years after diagnosis, and complete remission is still rare. Tobacco smoking is a major risk factor of pancreatic cancer. However, the mechanism(s) through which it causes the disease remains unknown. Accumulating evidence indicates that carcinogenic compounds in cigarette smoke stimulate pancreatic cancer progression through induction of inflammation and fibrosis which act in concert with genetic factors leading to the inhibition of cell death and stimulation of proliferation resulting in the promotion of the PDAC.
Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies
2011, European Journal of Cancer
Citation Excerpt :
A total of thirty-five cohort studies, which met the inclusion and exclusion criteria, were used in this meta-analysis (Tables 1 and 2). Of these 35 studies, 27 studies employed incidence and/or mortality rates as the measurement of relative risk10,12–20,29–45 (Table 1), and 8 cohort studies used SIR/SMR as the measurement of relative risk46–53 (Table 2). The countries in which the studies were conducted were as follows: Japan (n = 5)14,15,35,37,43; the United States (n = 14),10,16–18,29,30,32,33,38,40,42,44,47,48 Europe(n = 13)13,19,20,31,34,36,39,46,49–53, Asia-Pacific Region (n = 1)41; Israel (n = 1)45 and Korea (n = 1).12
Diabetes mellitus (DM) is widely considered to be associated with risk of pancreatic cancer (PaC), however, whether DM is a cause or a consequence of PaC is still controversial. We examined this association by conducting a detailed meta-analysis of cohort studies.
Studies were identified by searching Medline and Embase through November 30, 2010. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model.
A total of thirty-five cohort studies were included in this meta-analysis. DM was associated with an increased risk of PaC (the summary RRs = 1.94; 95% CI, 1.66–2.27), with significant evidence of heterogeneity among these studies (p < 0.001, I² = 93.6%). Subgroup analyses revealed that the increased risk of PaC was independent of geographic locations, sex, study design, alcohol consumption, body mass index (BMI) and smoking status. In addition, the relative risk of PaC was correlated negatively with the duration of DM, with the highest risk of PaC found among patients diagnosed within less than 1 year. There was no significant publication bias (p = 0.136 for Egger’s regression asymmetry test).
Findings from this meta-analysis strongly support that diabetes is associated with an increased risk of PaC in both males and females and that DM is both an early manifestation and an etiologic factor of pancreatic cancer.
Tea and cancer prevention: Epidemiological studies
2011, Pharmacological Research
Citation Excerpt :
The remaining 9 case–control studies reported a null association between black tea consumption and pancreatic cancer risk. In addition, 8 publications derived from 9 cohort studies evaluated associations between black tea consumption and pancreatic cancer risk [35,38,72–77]. Two of them demonstrated an inverse association [72,74] while five others did not find any association [38,35,73,75,76].
Experimental studies have consistently shown the inhibitory activities of tea extracts on tumorigenesis in multiple model systems. Epidemiological studies, however, have produced inconclusive results in humans. A comprehensive review was conducted to assess the current knowledge on tea consumption and risk of cancers in humans. In general, consumption of black tea was not associated with lower risk of cancer. High intake of green tea was consistently associated with reduced risk of upper gastrointestinal tract cancers after sufficient control for confounders. Limited data support a protective effect of green tea on lung and hepatocellular carcinogenesis. Although observational studies do not support a beneficial role of tea intake on prostate cancer risk, phase II clinical trials have demonstrated an inhibitory effect of green tea extract against the progression of prostate pre-malignant lesions. Green tea may exert beneficial effects against mammary carcinogenesis in premenopausal women and recurrence of breast cancer. There is no sufficient evidence that supports a protective role of tea intake on the development of cancers of the colorectum, pancreas, urinary tract, glioma, lymphoma, and leukemia. Future prospective observational studies with biomarkers of exposure and phase III clinical trials are required to provide definitive evidence for the hypothesized beneficial effect of tea consumption on cancer formation in humans.
Pancreatic Cancer: A Review of the Evidence on Causation
2008, Clinical Gastroenterology and Hepatology
Pancreatic cancer kills more than 250,000 people each year worldwide and has a poor prognosis. The aim of this article is to critically review the epidemiologic evidence for exposures that may either increase or decrease the risk. A Medline search was performed for epidemiologic studies and reviews published up to April 2007. Consistent evidence of a positive association was found for family history and cigarette smoking. Many studies documented a positive association with diabetes mellitus and chronic pancreatitis, although the etiologic mechanisms are unclear. Other associations were detected, but the results were either inconsistent or from few studies. These included positive associations with red meat, sugar, fat, body mass index, gallstones, and Helicobacter pylori, and protective effects of increasing parity, dietary folate, aspirin, and statins. There was no evidence linking alcohol or coffee consumption with an increased risk of pancreatic cancer. The associations with many exposures need to be clarified from further epidemiologic work in which there is both precise measurement of risk factors, adjustment for potential confounders, and, for dietary studies, information recorded on the method of food preparation and pattern of consumption. Such work is important to reduce the incidence of this fatal disease.

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^☆: Report number XXI in a series on chronic disease in former college students.

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Original articleEarly precursors of pancreatic cancer in college men☆

Abstract

Lancet

Coffee and cancer of the pancreas

N Engl J Med

A multifactorial model for pancreatic cancer in man

JAMA

Epidemiology of cancer of the pancreas

J Natl Cancer Inst

Mortality in relation to smoking: 20 years' observations of male British doctors

BR MED J

The Dorn study of smoking and mortality among U.S. veterans: report on eight and one-half years of observation

Smoking and mortality; a prospective study

Cancer

Smoking in relation to the death rates of one million men and women

Correspondence. Coffee and cancer of the pancreas

N Engl J Med

Coffee and pancreatic cancer

JAMA

Original article
Early precursors of pancreatic cancer in college men☆