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Pancreatology. 2015 Mar-Apr;15(2):151-5. doi: 10.1016/j.pan.2015.01.013. Epub 2015 Feb 12.

Early onset pancreatic cancer: risk factors, presentation and outcome.

Author information

1
Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
2
Endoscopy Division, Gemelli Hospital, Faculty of Medicine and Surgery, Catholic University of Rome, Italy.
3
Oncology Department, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
4
General Surgery Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
5
Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. Electronic address: gianfranco.dellefave@uniroma1.it.

Abstract

BACKGROUND:

About 10% of pancreatic cancer patients are aged ≤50 at diagnosis and defined as Early Onset Pancreatic Cancer (EOPC). There is limited information regarding risk factors for EOPC occurrence and their outcome.

AIM:

To investigate risk factors, presentation features and outcome of EOPC patients.

METHODS:

Consecutive, histologically confirmed, pancreatic cancer patients enrolled. Data regarding environmental and genetic risk factors, clinical and pathological information, treatment and survival were recorded. EOPC patients (aged ≤50 at diagnosis) were compared to older subjects.

RESULTS:

Twenty-five of 293 patients (8.5%) had EOPC. There was no difference regarding sex distribution, medical conditions and alcohol intake between EOPC and older subjects. EOPC patients were more frequently current smokers (56% vs 28% p = 0.001) and started smoking at a significantly lower mean age (19.8 years, 95%CI 16.7-22.9) as compared to older patients (26.1, 95%CI 24.2-28) (p = 0.001). Current smoking (OR 7.5; 95%CI 1.8-30; p = 0.004) and age at smoking initiation (OR 0.8 for every increasing year; 95%CI 0.7-0.9; p = 0.01) were significant and independent risk factors for diagnosis of EOPC. There were no differences regarding genetic syndromes and pancreatic cancer family history. EOCP presented less frequently with jaundice (16% vs 44%, p = 0.006) and had a higher rate of unresectable disease, albeit not significantly (84% vs 68%, p = 0.1). EOPC patients were more frequently fit for surgery or chemotherapy than their counterpart, resulting in similar stage-specific survival probability.

CONCLUSION:

EOPC seems related to active and early smoking but not to familial syndromes. Young patients display aggressive disease but not worse outcome.

KEYWORDS:

Early onset; Family history; Metastasis; Pancreatic cancer; Smoking; Survival

PMID:
25708929
DOI:
10.1016/j.pan.2015.01.013
[Indexed for MEDLINE]

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