Pancreatitis and pancreatic cancer risk: A pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4)

E. J. Duell, E. Lucenteforte, S. H. Olson, P. M. Bracci, D. Li, H. A. Risch, D. T. Silverman, B. T. Ji, S. Gallinger, E. A. Holly, E. H. Fontham, P. Maisonneuve, H. B. Bueno-de-Mesquita, P. Ghadirian, R. C. Kurtz, E. Ludwig, H. Yu, A. B. Lowenfels, D. Seminara, G. M. PetersenC. La Vecchia, P. Boffetta

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121 Scopus citations

Abstract

Background: Pancreatitis is a known risk factor for pancreatic cancer; however, an unknown fraction of the disease is thought to be a consequence of tumor-related duct obstruction. Patients and methods: A pooled analysis of a history of pancreatitis and risk of pancreatic cancer was carried out considering the time interval between diagnoses and potential modification by covariates. Adjusted pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from 10 case-control studies (5048 cases of ductal pancreatic adenocarcinoma and 10 947 controls) taking part in the International Pancreatic Cancer Case-Control Consortium (PanC4). Results: The association between pancreatitis and pancreatic cancer was nearly three-fold at intervals of >2 years between diagnoses (OR: 2.71, 95% CI: 1.96-3.74) and much stronger at intervals of ≤2 years (OR: 13.56, 95% CI: 8.72-21.90) probably reflecting a combination of reverse causation and antecedent misdiagnosis of pancreas cancer as pancreatitis. The younger (<65 years) pancreatic cancer cases showed stronger associations with previous (>2 years) pancreatitis (OR: 3.91, 95% CI: 2.53-6.04) than the older (≥65 years) cases (OR: 1.68, 95% CI: 1.02-2.76; P value for interaction: 0.006). Conclusions: Despite a moderately strong association between pancreatitis (diagnosed before >2 years) and pancreatic cancer, the population attributable fraction was estimated at 1.34% (95% CI: 0.612-2.07%), suggesting that a relatively small proportion of pancreatic cancer might be avoided if pancreatitis could be prevented.

Original languageEnglish (US)
Article numbermds140
Pages (from-to)2964-2970
Number of pages7
JournalAnnals of Oncology
Volume23
Issue number11
DOIs
StatePublished - Nov 1 2012

Keywords

  • Case-control studies
  • Pancreatic cancer
  • Pancreatitis
  • Pooled analysis
  • Risk factors

ASJC Scopus subject areas

  • Hematology
  • Oncology

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    Duell, E. J., Lucenteforte, E., Olson, S. H., Bracci, P. M., Li, D., Risch, H. A., Silverman, D. T., Ji, B. T., Gallinger, S., Holly, E. A., Fontham, E. H., Maisonneuve, P., Bueno-de-Mesquita, H. B., Ghadirian, P., Kurtz, R. C., Ludwig, E., Yu, H., Lowenfels, A. B., Seminara, D., ... Boffetta, P. (2012). Pancreatitis and pancreatic cancer risk: A pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). Annals of Oncology, 23(11), 2964-2970. [mds140]. https://doi.org/10.1093/annonc/mds140