Risk of pancreatic cancer associated with family history of cancer and other medical conditions by accounting for smoking among relatives
Por:
Molina-Montes, E, Gomez-Rubio, P, Marquez, M, Rava, M, Lohr, M, Michalski, CW, Molero, X, Farre, A, Perea, J, Greenhalf, W, Ilzarbe, L, O'Rorke, M, Tardon, A, Gress, T, Barbera, VM, Crnogorac-Jurcevic, T, Dominguez-Munoz, E, Munoz-Bellvis, L, Balsells, J, Costello, E, Huang, J, Iglesias, M, Kleeff, J, Kong, B, Mora, J, Murray, L, O'Driscoll, D, Poves, I, Scarpa, A, Ye, W, Hidalgo, M, Sharp, L, Carrato, A, Real, FX, Malats, N, PanGenEU Study Investigators
Publicada:
1 abr 2018
Resumen:
Background: Family history (FH) of pancreatic cancer (PC) has been associated with an increased risk of PC, but little is known regarding the role of inherited/environmental factors or that of FH of other comorbidities in PC risk. We aimed to address these issues using multiple methodological approaches.
Methods: Case-control study including 1431 PC cases and 1090 controls and a reconstructed-cohort study (N = 16747) made up of their first-degree relatives (FDR). Logistic regression was used to evaluate PC risk associated with FH of cancer, diabetes, allergies, asthma, cystic fibrosis and chronic pancreatitis by relative type and number of affected relatives, by smoking status and other potential effect modifiers, and by tumour stage and location. Familial aggregation of cancer was assessed within the cohort using Cox proportional hazard regression.
Results: FH of PC was associated with an increased PC risk [odds ratio (OR) = 2.68; 95% confidence interval (CI): 2.27-4.06] when compared with cancer-free FH, the risk being greater when >= 2 FDRs suffered PC (OR = 3.88; 95% CI: 2.96-9.73) and among current smokers (OR = 3.16; 95% CI: 2.56-5.78, interaction FHPC* smoking P-value = 0.04). PC cumulative risk by age 75 was 2.2% among FDRs of cases and 0.7% in those of controls [hazard ratio (HR) = 2.42; 95% CI: 2.16-2.71]. PC risk was significantly associated with FH of cancer (OR = 1.30; 95% CI: 1.13-1.54) and diabetes (OR = 1.24; 95% CI: 1.01-1.52), but not with FH of other diseases.
Conclusions: The concordant findings using both approaches strengthen the notion that FH of cancer, PC or diabetes confers a higher PC risk. Smoking notably increases PC risk associated with FH of PC. Further evaluation of these associations should be undertaken to guide PC prevention strategies.
Filiaciones:
Molina-Montes, E:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
CIBERONC, Valencia, Spain
Gomez-Rubio, P:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
CIBERONC, Valencia, Spain
Marquez, M:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
CIBERONC, Valencia, Spain
Rava, M:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
CIBERONC, Valencia, Spain
Lohr, M:
Karolinska Inst, Stockholm, Sweden
Univ Hosp, Gastroctr, Stockholm, Sweden
Michalski, CW:
Tech Univ Munich, Dept Surg, Munich, Germany
Heidelberg Univ, Dept Surg, Heidelberg, Germany
Molero, X:
Univ Autonoma Barcelona, Vall dHebron Res Inst VHIR, Hosp Univ Vall dHebron, Barcelona, Spain
CIBEREHD, Barcelona, Spain
Farre, A:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Barcelona, Spain
Perea, J:
Univ Hosp 12 Octubre, Dept Surg, Madrid, Spain
Greenhalf, W:
Royal Liverpool Univ Hosp, Dept Mol & Clin Canc Med, Liverpool, Merseyside, England
Ilzarbe, L:
Hosp Mar Parc Salut Mar, Barcelona, Spain
O'Rorke, M:
Queens Univ Belfast, Ctr Publ Hlth, Belfast, Antrim, North Ireland
Tardon, A:
Inst Univ Oncol Principado Asturias, Dept Med, Oviedo, Spain
CIBERESP, Barcelona, Spain
Gress, T:
Univ Hosp Giessen & Marburg, Dept Gastroenterol, Marburg, Germany
Barbera, VM:
Gen Univ Hosp Elche, Mol Genet Lab, Elche, Spain
Crnogorac-Jurcevic, T:
Queen Mary Univ London, Ctr Mol Oncol, Barts Canc Inst, London, England
Dominguez-Munoz, E:
Univ Clin Hosp Santiago de Compostela, Dept Gastroenterol, Santiago De Compostela, Spain
Munoz-Bellvis, L:
Salamanca Univ Hosp, Gen & Digest Surg Dept, Salamanca, Spain
Balsells, J:
Univ Autonoma Barcelona, Vall dHebron Res Inst VHIR, Hosp Univ Vall dHebron, Barcelona, Spain
CIBEREHD, Barcelona, Spain
Costello, E:
Royal Liverpool Univ Hosp, Dept Mol & Clin Canc Med, Liverpool, Merseyside, England
Huang, J:
Karolinska Inst, Stockholm, Sweden
Univ Hosp, Gastroctr, Stockholm, Sweden
Iglesias, M:
Hosp Mar Parc Salut Mar, Barcelona, Spain
Kleeff, J:
Tech Univ Munich, Dept Surg, Munich, Germany
Martin Luther Univ Halle Wittenberg, Dept Visceral Vasc & Endocrine Surg, Halle, Germany
Kong, B:
Tech Univ Munich, Dept Surg, Munich, Germany
Mora, J:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Barcelona, Spain
Murray, L:
Queens Univ Belfast, Ctr Publ Hlth, Belfast, Antrim, North Ireland
O'Driscoll, D:
Univ Coll Cork, Natl Canc Registry Ireland, Cork, Ireland
Univ Coll Cork, HRB Clin Res Facil, Cork, Ireland
Poves, I:
Hosp Mar Parc Salut Mar, Barcelona, Spain
Scarpa, A:
Univ & Hosp Trust Verona, ARC Net Ctr Appl Res Canc, Verona, Italy
Univ & Hosp Trust Verona, Dept Pathol & Diagnost, Verona, Italy
Ye, W:
Karolinska Inst, Stockholm, Sweden
Univ Hosp, Gastroctr, Stockholm, Sweden
Hidalgo, M:
Madrid Norte Sanchinarro Hosp, Madrid, Spain
Sharp, L:
Univ Coll Cork, Natl Canc Registry Ireland, Cork, Ireland
Univ Coll Cork, HRB Clin Res Facil, Cork, Ireland
Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne, Tyne & Wear, England
Carrato, A:
CIBERONC, Valencia, Spain
Alcala Univ, IRYCIS, Dept Oncol, Ramon y Cajal Univ Hosp, Madrid, Spain
Real, FX:
CIBERONC, Valencia, Spain
Univ Pompeu Fabra, Dept Ciencies Expt & Salut, Spanish Natl Canc Res Ctr CNIO, Epithelial Carcinogenesis Grp, Barcelona, Spain
Malats, N:
Spanish Natl Canc Res Ctr CNIO, Genet & Mol Epidemiol Grp, Madrid, Spain
CIBERONC, Valencia, Spain
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