Medical History, Medications, and Pancreatic Cancer Risk

描述（由申请人提供）： 胰腺癌的危险因素尚未明确。本研究的目的是通过病例对照研究，基于病历摘要、电子实验室和药房数据，调查病史、药物使用与胰腺癌之间的关系。 我们的具体目标是： 1.调查医疗条件与胰腺癌风险之间的关系，重点是： a.糖尿病，包括病程、治疗和血糖控制。 B.胰腺炎，包括急性和慢性胰腺炎。 C.消化性溃疡病和/或幽门螺杆菌（H. pylori）。 D.胆囊切除术和/或胆石病史。 2.研究药物使用与胰腺癌之间的关系，重点关注非甾体抗炎药、降胆固醇药物（包括HMG-CoA还原酶抑制剂）和抑酸药物（包括组胺受体拮抗剂和质子泵抑制剂）。 作为第二个具体目标，我们建议检查额外的医疗条件和药物，以便为胰腺癌的流行病学和预防的未来研究产生假设。这些包括评估医疗条件，如肠易激综合征，过敏和哮喘以及药物，包括免疫抑制药物和血管紧张素转换酶抑制剂。 为了实现这些具体目标，我们建议进行一项胰腺癌病例对照研究，包括250例新诊断病例和1,000例对照，在一个大型健康维护组织团体健康合作社的定义人群中。将通过提取传统和计算机化病历（包括电子实验室和药房数据）收集既往医疗状况和用药数据。研究的优势包括统一收集的长期医疗和药房数据的可用性以及重要协变量（包括吸烟）数据的可用性。这项拟议的研究将提供一个独特的机会，调查医疗条件和药物在胰腺肿瘤发生中的作用，并对导致胰腺癌的机制产生新的见解。

DESCRIPTION (provided by applicant): Risk factors for pancreatic cancer are not well established. The goal of this pilot study is to investigate the relation between medical history, medication use and pancreatic cancer in a case-control study based on medical record abstraction and electronic laboratory and pharmacy data. Our specific aims are: 1. To investigate the relation between medical conditions and pancreatic cancer risk, focusing on: a. Diabetes mellitus, including disease duration, therapy, and glycemic control. b. Pancreatic inflammation, including acute and chronic pancreatitis. c. History of peptic ulcer disease and/or infection with Helicobacter pylori (H. pylori). d. History of cholecystectomy and/or cholelithiasis. 2. To investigate the relation between the use of medications and pancreatic cancer, focusing on nonsteroidal anti-inflammatory drugs, cholesterol lowering agents including HMG-CoA reductase inhibitors and acid suppressive medications including histamine receptor antagonists and proton pump inhibitors. As a secondary specific aim we propose to examine additional medical conditions and medications in order to generate hypotheses for future studies of the epidemiology and prevention of pancreatic cancer. These include evaluation of medical conditions such as irritable bowel syndrome, allergies and asthma as well as medications including immunosuppressive medications and angiotensin converting enzyme inhibitors. To meet these specific aims we propose to conduct a case-control study of pancreatic cancer comprised of 250 newly diagnosed cases and 1,000 controls in the defined population of Group Health Cooperative, a large health maintenance organization. Data on prior medical conditions and medications will be collected through abstraction of traditional and computerized medical records, including electronic laboratory and pharmacy data. Study strengths include the availability of uniformly collected, long-term medical and pharmacy data and the availability of data on important covariates, including smoking. The proposed study will provide a unique opportunity to investigate the role of medical conditions and medications in pancreatic tumorigenesis and to generate new insights into the mechanisms that result in pancreatic cancer.