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Med J Aust. 2019 Mar;210(5):213-220. doi: 10.5694/mja2.12108. Epub 2019 Jan 18.

The burden of pancreatic cancer in Australia attributable to smoking.

Author information

1
Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW.
2
Cancer Council Victoria, Melbourne, VIC.
3
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC.
4
Cancer Council NSW, Sydney, NSW.
5
University of Sydney, Sydney, NSW.
6
Prince of Wales Clinical School, University of New South Wales, Sydney, NSW.
7
Baker Heart and Diabetes Institute, Melbourne, VIC.
8
Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW.
9
Adelaide Medical School, University of Adelaide, Adelaide, SA.
10
Charles Perkins Centre, University of Sydney, Sydney, NSW.
11
ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW.
12
Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW.
13
Australian National University, Canberra, ACT.
14
Cancer Voices South Australia, Adelaide, SA.

Abstract

OBJECTIVE:

To estimate the burden of pancreatic cancer in Australia attributable to modifiable exposures, particularly smoking.

DESIGN:

Prospective pooled cohort study.

SETTING, PARTICIPANTS:

Seven prospective Australian study cohorts (total sample size, 365 084 adults); participant data linked to national registries to identify cases of pancreatic cancer and deaths.

MAIN OUTCOME MEASURES:

Associations between exposures and incidence of pancreatic cancer, estimated in a proportional hazards model, adjusted for age, sex, study, and other exposures; future burden of pancreatic cancer avoidable by changes in exposure estimated as population attributable fractions (PAFs) for whole population and for specific population subgroups with a method accounting for competing risk of death.

RESULTS:

There were 604 incident cases of pancreatic cancer during the first 10 years of follow-up. Current and recent smoking explained 21.7% (95% CI, 13.8-28.9%) and current smoking alone explained 15.3% (95% CI, 8.6-22.6%) of future pancreatic cancer burden. This proportion of the burden would be avoidable over 25 years were current smokers to quit and there were no new smokers. The burden attributable to current smoking is greater for men (23.9%; 95% CI, 13.3-33.3%) than for women (7.2%; 95% CI, -0.4% to 14.2%; P = 0.007) and for those under 65 (19.0%; 95% CI, 8.1-28.6%) than for older people (6.6%; 95% CI, 1.9-11.1%; P = 0.030). There were no independent relationships between body mass index or alcohol consumption and pancreatic cancer.

CONCLUSIONS:

Strategies that reduce the uptake of smoking and encourage current smokers to quit could substantially reduce the future incidence of pancreatic cancer in Australia, particularly among men.

KEYWORDS:

Cancer; Longitudinal studies; Obesity; Pancreatic diseases; Population health; Prevention and control; Risk factors; Smoking

PMID:
30656698
DOI:
10.5694/mja2.12108

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