학술논문
Excess pancreatic cancer risk due to smoking and modifying effect of quitting smoking: The Multiethnic Cohort Study.
Document Type
Academic Journal
Author
Bogumil D; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA. dbogumil@usc.edu.; Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA. dbogumil@usc.edu.; Stram D; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA.; Preston DL; Hirosoft International, Eureka, CA, USA.; Pandol SJ; Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.; Department of Veterans Affairs, Los Angeles, CA, USA.; Wu AH; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA.; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; McKean-Cowdin R; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA.; Conti DV; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA.; Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; Setiawan VW; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Room 1517C, Los Angeles, CA, 90033, USA.; Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Source
Publisher: Kluwer Academic Publishers Country of Publication: Netherlands NLM ID: 9100846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7225 (Electronic) Linking ISSN: 09575243 NLM ISO Abbreviation: Cancer Causes Control Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Risk factors for pancreatic cancer include racial/ethnic disparities and smoking. However, risk trajectories by smoking history and race/ethnicity are unknown. We examined the association of smoking with pancreatic cancer by race/ethnicity to generate age-specific incidence estimates by smoking history.
Methods: We modeled pancreatic cancer incidence by race/ethnicity, age, pack-years, and years-quit using an excess relative risk model for 182,011 Multiethnic Cohort participants. We tested heterogeneity of smoking variables and pancreatic cancer by race/ethnicity and predicted incidence by smoking history.
Results: We identified 1,831 incident pancreatic cancer cases over an average 19.3 years of follow-up. Associations of pack-years (p interaction by race/ethnicity = 0.41) and years-quit (p interaction = 0.83) with pancreatic cancer did not differ by race/ethnicity. Fifty pack-years smoked was associated with 91% increased risk (95% CI 54%, 127%) relative to never smokers in the combined sample. Every year quit corresponded to 9% decreased excess risk (95% CI 2%, 15%) from pack-years smoked. Differences in baseline pancreatic cancer risk across racial/ethnic groups (p < 0.001) translated to large differences in risk for smokers at older ages across racial/ethnic groups (65-122 cases per 100,000 at age 70).
Conclusion: Smoking pack-years were positively associated with elevated pancreatic cancer risk. Predicted risk trajectories showed a high impact of smoking cessation at < 65 years. Although we did not identify significant heterogeneity in the association of pack-years or years quit with pancreatic cancer risk, current smoker risk varied greatly by race/ethnicity in later life due to large differences in baseline risk.
(© 2023. The Author(s).)
Methods: We modeled pancreatic cancer incidence by race/ethnicity, age, pack-years, and years-quit using an excess relative risk model for 182,011 Multiethnic Cohort participants. We tested heterogeneity of smoking variables and pancreatic cancer by race/ethnicity and predicted incidence by smoking history.
Results: We identified 1,831 incident pancreatic cancer cases over an average 19.3 years of follow-up. Associations of pack-years (p interaction by race/ethnicity = 0.41) and years-quit (p interaction = 0.83) with pancreatic cancer did not differ by race/ethnicity. Fifty pack-years smoked was associated with 91% increased risk (95% CI 54%, 127%) relative to never smokers in the combined sample. Every year quit corresponded to 9% decreased excess risk (95% CI 2%, 15%) from pack-years smoked. Differences in baseline pancreatic cancer risk across racial/ethnic groups (p < 0.001) translated to large differences in risk for smokers at older ages across racial/ethnic groups (65-122 cases per 100,000 at age 70).
Conclusion: Smoking pack-years were positively associated with elevated pancreatic cancer risk. Predicted risk trajectories showed a high impact of smoking cessation at < 65 years. Although we did not identify significant heterogeneity in the association of pack-years or years quit with pancreatic cancer risk, current smoker risk varied greatly by race/ethnicity in later life due to large differences in baseline risk.
(© 2023. The Author(s).)