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Int J Cancer. 2017 Aug 15;141(4):687-693. doi: 10.1002/ijc.30773. Epub 2017 May 19.

Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies.

Author information

1
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
2
Centre for Epidemiology and Community Medicine, Stockholm Health Care District, Stockholm County Council, Sweden.
3
Department of Clinical Sciences, Lund University, Lund, Sweden.
4
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
5
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
6
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
7
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
8
Division of Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
9
Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
10
Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Huddinge, Stockholm, Sweden.
11
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
12
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
13
Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Lund, Sweden.

Abstract

While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.

KEYWORDS:

incidence; pancreatic cancer; snus

PMID:
28486772
DOI:
10.1002/ijc.30773
[Indexed for MEDLINE]
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