Predictors of pancreatic cancer mortality among a large cohort of United States adults
Predictors of pancreatic cancer mortality among a large cohort of United States adults
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DOI：
10.1023/a:1026580131793
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发表时间：
2000-12-01
影响因子：
2.3
通讯作者：
Thun, MJ
中科院分区：
文献类型：
--
作者：
Coughlin, SS;Calle, EE;Thun, MJ
目的：吸烟被认为是胰腺癌的重要危险因素，但其他所谓的危险因素还不是很清楚。为了更多地了解这一重要死亡原因的流行病学，我们在一项针对美国成年人的大型前瞻性研究中检查了各种可能的胰腺癌死亡危险因素的相关性。方法：我们使用比例风险模型来获得相对风险(风险比)的调整估计。在14年的随访期中，在483,109名男性和619,199名女性中，3751人死于胰腺癌，这些人在1982年登记时没有癌症病史。结果：基线吸烟与男性(多变量相对危险度[RR]=2.1，95%可信区间[CI]1.9~2.4)和女性(RR=2.0，95%CI=1.8~2.3)的致命性胰腺癌相关。在当前吸烟者中，在基线水平上，随着每天吸烟数量的增加，观察到了风险的趋势。在男性和女性的不同模型中包括了几个变量，我们发现其他因素可以预测胰腺癌死亡率，包括胰腺癌家族史、黑人种族、糖尿病和体重指数增加。胆结石病史是男性患胰腺癌的预测因素。结论：我们的研究结果证实吸烟是胰腺癌死亡率的一个重要预测因素，并确定了其他几个可能导致风险增加的因素。
Objectives: Cigarette smoking is considered an important risk factor for pancreatic cancer, but other purported risk factors are less well established. To learn more about the epidemiology of this important cause of mortality we examined associations with a variety of possible risk factors for death from pancreatic cancer in a large, prospective study of United States adults.Methods: We used proportional hazards models to obtain adjusted estimates of relative risks (hazards ratios). During 14 years of follow-up, 3751 persons died of pancreatic cancer in a cohort of 483,109 men and 619,199 women who had no reported history of cancer at enrollment in 1982.Results: Cigarette smoking at baseline was associated with fatal pancreatic cancer among men (multivariate relative risk [RR] = 2.1, 95% confidence interval [CI] 1.9-2.4) and among women (RR = 2.0, 95% CI 1.8-2.3). A trend in risk was observed with increasing number of cigarettes smoked per day among current smokers at baseline. With several variables included in separate models for men and women, we found additional factors to be predictive of pancreatic cancer mortality, including family history of pancreatic cancer, black race, diabetes, and increased body mass index. History of gallstones was predictive of pancreatic cancer among men. An inverse association with vegetable consumption was observed among men, that was not statistically significant.Conclusion: Our findings confirm that cigarette smoking is an important predictor of pancreatic cancer mortality, and identify several other factors that may contribute to increased risk.