Factors associated with incident and fatal pancreatic cancer in a cohort of middle-aged women

Authors

  • Richard J. Stevens,

    Corresponding author
    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
    • Department of Primary Health Care, University of Oxford, Old Road, Oxford OX3 7LF, United Kingdom
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    • Fax: +44 1865-289287

  • Andrew W. Roddam,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • Elizabeth A. Spencer,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • Kirstin L. Pirie,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • Gillian K. Reeves,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • Jane Green,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • Valerie Beral,

    1. Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, United Kingdom
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  • on behalf of the Million Women Study Collaborators

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    • Million Women Study Collaborators.

      Steering Committee: Joan Austoker, Cancer Research UK Primary Care Education Research Group, Oxford, United Kingdom; Emily Banks, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia; Valerie Beral, Gillian Reeves, Cancer Epidemiology Unit, Oxford, United Kingdom; Judith Church (lay member), Ruth English, Oxford Radcliffe Hospital NHS Trust, The Churchill Hospital, Oxford, United Kingdom; Julietta Patnick, NHS Cancer Screening Programmes, Sheffield, United Kingdom; Richard Peto, Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, United Kingdom; Martin Vessey, St Cross College, Oxford, United Kingdom; Matthew Wallis, Addenbrokes Hospital, Cambridge, United Kingdom.

      Million Women Study Coordinating Centre Staff: Simon Abbott, Krys Baker, Angela Balkwill, Sue Bellenger, Valerie Beral, Judith Black, Anna Brown, Diana Bull, Delphine Casabonne, Barbara Crossley, Dave Ewart, Sarah Ewart, Lee Fletcher, Toral Gathani, Laura Gerrard, Adrian Goodill, Jane Green, Winifred Gray, Joy Hooley, Sau Wan Kan, Carol Keene, Nicky Langston, Bette Liu, Sarit Nehushtan, Lynn Pank, Kirstin Pirie, Gillian Reeves, Andrew Roddam, Emma Sherman, Moya Simmonds, Elizabeth Spencer, Richard Stevens, Helena Strange, Sian Sweetland, Aliki Taylor, Alison Timadjer, Sarah Tipper, Joanna Watson, Stephen Williams, Cancer Epidemiology Unit, Oxford, United Kingdom.

      Collaborating UK NHS Breast Screening Centres: E.D.C. Anderson, Scottish Breast Screening Programme, Edinburgh, United Kingdom; G. Athey, Breast Screening Service, West Cumberland Hospital, Cumbria, United Kingdom; R. Bannon, Breast Screening Unit, West Suffolk Hospital, Bury St Edmunds, United Kingdom; S. Barker, Cambridge Breast Unit, Addenbrookes Hospital, Cambridge, United Kingdom; N.K. Barrett, West of London Breast Screening Service, Charing Cross Hospital, London, United Kingdom; C.H. Beattie, Breast Screening Unit, Women's Hospital, Liverpool, United Kingdom; M.G. Bell, West Berkshire Breast Screening Service, Reading, United Kingdom; R. Bhatt, Breast Screening Service, City Hospital NHS Trust, Birmingham, United Kingdom; S. Bradley, Breast Screening Service, Birmingham Women's Hospital, Birmingham, United Kingdom; D. Brown, East of Scotland Breast Screening Centre, Ninewells Hospital, Dundee, United Kingdom; K.L. Cheung, The Breast Institute, City Hospital, Nottingham, United Kingdom; J. Cooke, Jarvis Breast Screening Diagnostic and Training Centre, Surrey, United Kingdom; E.J. Cornford, Welcome Centre Breast Screening Unit, The Kings Mill Centre For Health Care Services, Sutton-in Ashfield, United Kingdom; M. Creagh-Barry, The Dorset Breast Screening Unit, Dorset, United Kingdom; M. Crotch-Harvey, Victoria Breast Centre Macclesfield District General Hospital, Cheshire, United Kingdom; H. Daintith, Leicestershire Breast Screening Service, Glenfield Hospital NHS Trust, Leicester, United Kingdom; C. Dale, Breast Screening Service, Princess of Wales Community Hospital, Bromsgrove, United Kingdom; R. Davies, East Devon Breast Screening Unit, Royal Devon and Exeter Hospital, Exeter, United Kingdom; H. Deans, North East Scotland Breast Screening Centre, Aberdeen, United Kingdom; A. Duncan and R. Ramachandra, Breast Screening Unit, Coventry and Warwick Hospital, Coventry, United Kingdom; R. English, The Breast Care Unit, Oxford Radcliffe Hospital NHS Trust, The Churchill Hospital, Oxford, United Kingdom; A. Fielding, Shropshire Health Authorities, Shrewsbury, United Kingdom; S. Gelep, Breast Screening Unit, Barnsley District General Hospital, Barnsley, United Kingdom; D. Green, Wirral Breast Sceening Unit, Clatterbridge Hospital, Bebington, United Kingdom; P.E. Gordon, Patricia Massey Breast Screening Unit, Queen Alexandra Hospital, Hants, United Kingdom; M. Hall, Windsor Breast Diagnostic Centre, King Edward V11 Hospital, Berks, United Kingdom; A. Havard, Breast Screening Unit, Milton Keynes General Hospital NHS Trust, Milton Keynes, United Kingdom; R.N. Harland South Lancashire Breast Screening Unit, Thomas Linacre Out, Wigan, United Kingdom; P.J. Hendry, North of Scotland Breast Screening Service, Raigmore Hospital, Inverness, United Kingdom; F. Holly Archer, Breast Care Unit, James Paget Hospital, Great Yarmouth, United Kingdom; J.E. Houghton, Chester District Breast Screening Unit, Chester, United Kingdom; G. Hunnam, Breast Care Unit, Queen Elizabeth Hospital, King's Lynn, United Kingdom; C. Ingram, Sheffield Health, Sheffield, United Kingdom; P.A. Jones, Primrose Breast Care Unit, Derriford Hospital, Plymouth, United Kingdom; B. Kaye, Breast Screening Administration, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; E. Kutt, Avon Breast Screening, Central Health Clinic, Bristol, United Kingdom; J. Lavelle, North Lancashire and South Cumbria Breast Screening Service, Royal Lancaster Infirmary, Lancaster, United Kingdom; E. Lindsay, South West Scotland Breast Screening Service, Ayrshire Central Hospital, Irvine, United Kingdom; S. Lowe, Kent Breast Screening Service, Kent and Canterbury Hospital, Kent, United Kingdom; P. Loynes, South Staffordshire Breast Screening Service, Cannock Chase Hospital, Staffs, United Kingdom; L.G. Lunt, Breast Screening & Assessment Unit, Queen Elizabeth Hospital, Gateshead, United Kingdom; I.D. Lyburn, Gloucestershire Breast Screening Service, Glos, United Kingdom; A. Murphy, North Yorkshire Breast Screening Services, Screening Office York District Hospital, York, United Kingdom; G. O'Sullivan, Winchester Breast Screening Unit, Royal Hampshire County Hospital, Hants, United Kingdom; R. Pitcher, Mammography Unit, Royal Cornwall Hospital, Cornwall, United Kingdom; C. Record, Aylesbury Breast Screening Service, Stoke Mandeville Hospital NHS Trust, Bucks, United Kingdom; C. Record, Wycombe General Hospital, Bucks, United Kingdom; N. Rothnie, South Essex Breast Screening Service, Nightingale Centre Southend Hospital, Essex, United Kingdom; G. Rubin, Breast Assessment Centre, Royal Sussex County Hospital, Brighton, United Kingdom; J. Scally, Breast Screening Unit, Leighton Hospital, Cheshire, United Kingdom; A. Sever, The Peggy Wood Breast Care Centre, Maidstone Hospital, Kent, United Kingdom; A. Sheridan, Breast Screening Unit, Warrington Hospital, Cheshire, United Kingdom; O. Strukowska, The West Sussex Breast Screening Service, Worthing Hospital, West Sussex, United Kingdom; S. Taylor, Wiltshire Breast Screening Unit, The Great Western Hospital, Swindon, United Kingdom; W. Teh, North of London Breast Screening Service, Edgware Community Hospital, Edgware, United Kingdom; W.D. Thompson, Breast Screening Service, Cleveland, United Kingdom; R. Toye, Breast Screening Unit, Medway Hospital, Gillingham, United Kingdom; A. Turnbull, Breast Screening Unit, Derby City General Hospital, Derby, United Kingdom; S. Varkey, Rotherham Breast Screening and Assessment Unit, Rotherham General Hospital, Rotherham, United Kingdom; D.A. Ward, Doncaster Breast Screening Centre, Cameo Centre, Doncaster, United Kingdom; W.P. Whitear, Breast Sceening Centre, Ipswich Hospital NHS Trust, Ipswich, United Kingdom; R. Whitney, Chelmsford and Colchester Breast Screening Service, Essex County Hospital, Essex, United Kingdom; M. Wilson, Greater Manchester Breast Screening Service, Withington Hospital, Manchester, United Kingdom; S. Wilson, Somerset Breast Screening, Breast Care Centre, Musgrove Park Hospital, Somerset, United Kingdom; D. Wright, Breast Screening Service, Luton and Dunstable Hospital, Luton, United Kingdom.


Abstract

Risk factors for pancreatic cancer, other than smoking and diabetes, are not well-established, especially for women. In a cohort of 1.3 million middle-aged women, followed for 9.2 million person-years for cancer incidence and 11.5 million person-years for mortality, there were 1,338 incident pancreatic cancer cases and 1,710 deaths from the disease. Using proportional hazards models, we calculated adjusted relative risks (RRs) and 95% confidence intervals (CIs) by smoking, height, body mass index (BMI), alcohol consumption, physical activity and history of diabetes. Pancreatic cancer incidence was greater in current than never smokers (RR 2.39, CI 2.10–2.73), the risk increasing with the number of cigarettes smoked. The incidence of pancreatic cancer also increased with increasing BMI (RR 1.34, CI 1.13–1.57 for BMI ≥ 30 vs. 22.5–25 kg/m2), and with a history of diabetes (RR 1.58, CI 1.22–2.03, with vs. without such a history). These factors were also associated with increased mortality from pancreatic cancer. Height, alcohol consumption and physical activity showed little or no association with pancreatic cancer risk. © 2008 Wiley-Liss, Inc.

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