Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition
Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition
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DOI：
10.1002/ijc.24907
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发表时间：
2010-05-15
影响因子：
6.4
通讯作者：
Riboli, Elio
中科院分区：
文献类型：
--
作者：
Vrieling, Alina;Bueno-de-Mesquita, H. Bas;Riboli, Elio
吸烟是胰腺癌的一个既定的危险因素。然而，大多数欧洲国家的前瞻性数据缺乏，暴露于环境烟草烟雾（ETS）与胰腺癌风险相关的流行病学研究也很少。我们在欧洲癌症与营养前瞻性调查（EPIC）中研究了吸烟和暴露于ETS与胰腺癌风险的关系。这项分析基于465，910名参与者，其中包括524例首次发病的胰腺癌病例，这些病例在中位随访8.9年后被诊断出来。通过考克斯比例风险模型获得风险估计值，并根据体重、身高和糖尿病史进行校正。胰腺癌的风险增加，发现目前吸烟者与从未吸烟者相比（HR = 1.71，95%CI = 1.36 - 2.15），风险增加，更大的强度和包年。戒烟少于5年的前吸烟者患胰腺癌的风险增加（HR = 1.78，95%CI = 1.23-2.56），但戒烟5年或更长时间后，风险与从不吸烟者相当。在儿童时期每天暴露于ETS（许多小时）的从不吸烟者（HR = 2.61，95% CI = 0.96-7.10）和在家中和/或工作场所暴露于ETS（HR = 1.54，95% CI = 1.00-2.39）中，胰腺癌风险增加。这些结果表明，主动吸烟以及暴露于ETS都与胰腺癌风险增加有关，并且在戒烟后5年内，风险降低至从不吸烟者的水平。
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 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. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% Cl = 1.36 2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% Cl = 1.23-2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% Cl = 0.96-7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% Cl = 1.00-2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.