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Cancer Epidemiol Biomarkers Prev. 2019 May 21. pii: cebp.1327.2018. doi: 10.1158/1055-9965.EPI-18-1327. [Epub ahead of print]

Smoking and pancreatic cancer incidence: a pooled analysis of ten population-based cohort studies in Japan.

Author information

1
Division of Cancer Information & Control, Aichi Cancer Center Research Institute.
2
Division of Cancer Information & Control, Aichi Cancer Center Research Institute hidemi@aichi-cc.jp.
3
Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute.
4
Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine.
5
Center for Public Health Sciences, National Cancer Center.
6
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Centre.
7
Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine.
8
Department of Epidemiology & Preventive Medicine, Gifu University Graduate School of Medicine.
9
Faculty of Medicine, Hokkaido University.
10
Public Health, Aichi Medical University.
11
Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine.
12
Social Medicine, Osaka University Graduate School of Medicine.
13
Radiation Effects Research Foundation.
14
Department of Epidemiology, Radiation Effects Research Foundation.
15
Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center For Global Health and Medicine.
16
Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences.
17
Department of Preventive Medicine, Saga University Faculty of Medicine.
18
Division of Prevention, Center for Public Health Sciences, National Cancer Centre.

Abstract

BACKGROUND:

Detailed prospective evaluation of cigarette smoking associated with pancreatic cancer risk in large Asian populations is limited. The aim of this study was to examine this association in a Japanese population, with a particular focus on evaluating sex differences.

METHODS:

We performed a pooled analysis of ten population-based cohort studies. We calculated study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression, and then estimated summary HRs by pooling these estimates with a random effects model.

RESULTS:

During 4,695,593 person-years of follow-up in 354,154 participants, 1,779 incident pancreatic cancer cases were identified. We observed an increased pancreatic cancer risk for current smoking compared with never smoking in both males [HR (95% CI) 1.59 (1.32-1.91)] and females [1.81 (1.43-2.30)]. Significant risk elevations for former smoking and small cumulative dose of ≤ 20 pack-years were observed only among females, regardless of environmental tobacco smoke exposure. Trend analysis indicated significant 6% and non-significant 6% increases in pancreatic cancer risk for every 10 pack-years in males and females, respectively. Risk became comparable to never smokers after five years of smoking cessation in males. In females, however, we observed no risk attenuation by smoking cessation.

CONCLUSIONS:

This study supports the well-known association between smoking and pancreatic cancer and indicates potential sex differences in a Japanese population. Quitting smoking would be beneficial for pancreatic cancer prevention, especially in males.

IMPACT:

Pancreatic cancer risk is increased with cumulative smoking exposure and decreased with smoking cessation, with potential sex differences.

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