Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce.
We examined the association of cigarette smoking (current and lifetime intensity, duration, pack-years, time since quitting) and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus.
Current cigarette smokers had an elevated risk of pancreatic cancer compared to never smokers (hazard ratio (HR) = 1.71, 95% confidence interval (CI): 1.36, 2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 10 years were also at greater risk of pancreatic cancer (HR = 1.44, 95% CI: 1.06, 1.95), but risk was comparable to never smokers after quitting for 10 years or more. Further, pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.60, 95% CI: 0.95, 7.06) and exposed to ETS at home and/or work (HR = 1.54, 95% CI: 1.00, 2.39).
These results from a large European prospective cohort suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer.
Citation Information: Cancer Prev Res 2008;1(7 Suppl):A98.
- American Association for Cancer Research