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Seufferlein T, Mayerle J, Böck S, Brunner T, Ettrich TJ, Grenacher L, Gress TM, Hackert T, Heinemann V, Kestler A, Sinn M, Tannapfel A, Wedding U, Uhl W. S3-Leitlinie zum exokrinen Pankreaskarzinom – Langversion 2.0 – Dezember 2021 – AWMF-Registernummer: 032/010OL. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022; 60:e812-e909. [PMID: 36368658 DOI: 10.1055/a-1856-7346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Stefan Böck
- Medizinische Klinik und Poliklinik III, Universitätsklinikum München, Germany
| | - Thomas Brunner
- Universitätsklinik für Strahlentherapie-Radioonkologie, Medizinische Universität Graz, Austria
| | | | | | - Thomas Mathias Gress
- Klinik für Gastroenterologie und Endokrinologie, Universitätsklinikum Gießen und Marburg, Germany
| | - Thilo Hackert
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie Universitätsklinikum, Heidelberg, Germany
| | - Volker Heinemann
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München-Campus Grosshadern, München, Germany
| | | | - Marianne Sinn
- Universitätsklinikum Hamburg-Eppendorf Medizinische Klinik und Poliklinik II Onkologie Hämatologie, Hamburg, Germany
| | | | | | - Waldemar Uhl
- Allgemein- und Viszeralchirurgie, St Josef-Hospital, Bochum, Germany
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2
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Seufferlein T, Mayerle J, Böck S, Brunner T, Ettrich TJ, Grenacher L, Gress TM, Hackert T, Heinemann V, Kestler A, Sinn M, Tannapfel A, Wedding U, Uhl W. S3-Leitlinie zum exokrinen Pankreaskarzinom – Kurzversion 2.0 – Dezember 2021, AWMF-Registernummer: 032/010OL. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022; 60:991-1037. [PMID: 35671996 DOI: 10.1055/a-1771-6811] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | | | - Stefan Böck
- Medizinische Klinik und Poliklinik III, Universitätsklinikum München, Germany
| | - Thomas Brunner
- Universitätsklinik für Strahlentherapie-Radioonkologie, Medizinische Universität Graz, Austria
| | | | | | - Thomas Mathias Gress
- Klinik für Gastroenterologie und Endokrinologie, Universitätsklinikum Gießen und Marburg, Germany
| | - Thilo Hackert
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie Universitätsklinikum, Heidelberg, Germany
| | - Volker Heinemann
- Medizinische Klinik und Poliklinik III, Klinikum der Universität München-Campus Grosshadern, München, Germany
| | | | - Marianne Sinn
- Universitätsklinikum Hamburg-Eppendorf Medizinische Klinik und Poliklinik II Onkologie Hämatologie, Hamburg, Germany
| | | | | | - Waldemar Uhl
- Allgemein- und Viszeralchirurgie, St Josef-Hospital, Bochum, Germany
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3
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Grigor’eva IN. Pancreatic cancer risk: alcoholic and non-alcoholic beverages. TERAPEVT ARKH 2022; 94:265-270. [DOI: 10.26442/00403660.2022.02.201375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/22/2022]
Abstract
This article provides an overview of the metaanalyzes (PubMed, 19952019) of alcohol and non-alcoholic (coffee, tea, dairy products) beverage consumption in relation to risk of pancreatic cancer PC (PubMed, 19952019). Increased the PC risk was associated with high alcohol intake. The increased risk for heavy drinking did not explained by residual confounding by history of pancreatitis or tobacco smoking or diabetes. Light-moderate alcohol intake may reduced the PC risk, probably due to the fasting insulin levels decrement, which leads to the diminished the РС risk. The association between alcohol and the PC was stronger in men than in women. Some metaanalyzes demonstrated that a small amount of coffee may reduce PC risk, and a large amount to increase PC risk. Another meta-analyzes have not confirmed any association between the PC risk and coffee or tea consumption. One meta-analysis revealed a direct association of the PC risk with the dairy products consumption, but most research showed no such connection. Nutrition is considered to be associated with the PC risk, but the degree of risk due to structure of beverages consumption (dose, duration, alcohol, coffee, tea, dairy products pattern) is still not clear.
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Pourshahidi LK, Navarini L, Petracco M, Strain J. A Comprehensive Overview of the Risks and Benefits of Coffee Consumption. Compr Rev Food Sci Food Saf 2016; 15:671-684. [DOI: 10.1111/1541-4337.12206] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 12/12/2022]
Affiliation(s)
- L. Kirsty Pourshahidi
- Northern Ireland Centre for Food and Health (NICHE); Univ. of Ulster; Coleraine BT52 1SA UK
| | | | | | - J.J. Strain
- Northern Ireland Centre for Food and Health (NICHE); Univ. of Ulster; Coleraine BT52 1SA UK
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Mughetti M, Calculli L, Chiesa AM, Ciccarese F, Rrusho O, Pezzilli R. Implications and issues related to familial pancreatic cancer: a cohort study of hospitalized patients. BMC Gastroenterol 2016; 16:6. [PMID: 26767414 PMCID: PMC4714470 DOI: 10.1186/s12876-016-0421-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 01/08/2016] [Indexed: 02/06/2023] Open
Abstract
Background The surveillance of subjects at risk of pancreatic cancer is restricted to clinical research; the incidence of familial pancreatic cancer needs to be better established. Thus, we aimed to evaluate the frequency of familial pancreatic cancer in a population of hospitalized patients with pancreatic cancer. Methods A retrospective study based on the hospital charts of patients discharged with a diagnosis of pancreatic cancer. One hundred and eighty-seven patients or their relatives were called for a phone interview. Results There were 97 males (51.9 %) and 90 (48.1 %) females. The overall mean ± SD age was 67.3 ± 11.8 years; the age of males was similar to that of females (P = 0140). The mean size of the tumors found was 36.3 ± 17.4 mm (range of 5–110 mm); it was related to gender but was not related to the site of the tumor or the age of the patient. Regarding genetic diseases, three females (1.6 %) had familial adenomatous polyposis; three patients (1 male and two females) (1.6 %) had at least one relative with pancreatic cancer whereas only one 80-year old male patient (0.5 %) had two relatives affected by pancreatic cancer (the mother had died at the 65 years of age and the brother had died at 75 years of age). Conclusions The frequency of familial pancreatic ductal adenocarcinoma is small, but its importance, from the point of view of early diagnosis, is not negligible and patients with a risk of familial cancer merit an appropriate clinical follow-up.
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Affiliation(s)
- Martina Mughetti
- Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Lucia Calculli
- Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Anna Maria Chiesa
- Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Federica Ciccarese
- Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Odeta Rrusho
- Department of Diagnostic and Preventive Medicine, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
| | - Raffaele Pezzilli
- Pancreas Unit, Department of Digestive System, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy.
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6
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Zou L, Zhong R, Shen N, Chen W, Zhu B, Ke J, Lu X, Zhang T, Lou J, Wang Z, Liu L, Qi L, Miao X. Non-linear dose-response relationship between cigarette smoking and pancreatic cancer risk: evidence from a meta-analysis of 42 observational studies. Eur J Cancer 2013; 50:193-203. [PMID: 24054979 DOI: 10.1016/j.ejca.2013.08.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/11/2013] [Accepted: 08/19/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND Question remains about the shape of the dose-response relationship between cigarette smoking and pancreatic cancer risk. METHODS Relevant studies were identified by searching PubMed, ISI Web of Science and China National Knowledge Infrastructure (CNKI) databases and by reviewing the reference lists of retrieved articles. Random-effects models were applied to estimate summary relative risks (RRs). RESULTS Forty-two publications were finally included. The overall meta-analysis showed evidence of non-linear association between smoking intensity and pancreatic cancer risk (P for non-linearity=0.000). Compared with non-smokers, the summary RRs were 1.5 (95% confidence interval (CI): 1.4, 1.6) for 10 cigarettes/day, 1.9 (95% CI: 1.8, 2.0) for 20 cigarettes/day, 2.0 (95% CI: 1.9, 2.1) for 30 cigarettes/day and 2.1 (95% CI: 1.9, 2.3) for 40 cigarettes/day with marginal between-study heterogeneity (I(2)=29%). Similar results were also found for smoking duration and cumulative amount of cigarettes smoked. Besides, the summary RR for former smokers reduced with increasing time since quitting smoking compared with current smokers without heterogeneity (P for non-linearity=0.008, I(2)=0%). The results of stratified analysis by study design were comparable to those of overall meta-analysis. When stratified by sex, non-linear dose-response associations were detected for all metrics of cigarette smoking in women, while linear relationships were observed for smoking duration and cumulative amount of cigarettes smoked in men except for smoking intensity. CONCLUSION This meta-analysis reveals a non-linear dose-response association between cigarette smoking and pancreatic cancer risk, but it might differ between sexes.
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Affiliation(s)
- Li Zou
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Rong Zhong
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Na Shen
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Chen
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Beibei Zhu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Juntao Ke
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xuzai Lu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ti Zhang
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jiao Lou
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhenling Wang
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, USA
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health of MOE (Ministry of Education), Key Laboratory of Environment and Health of Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Bidel S, Hu G, Jousilahti P, Pukkala E, Hakulinen T, Tuomilehto J. Coffee consumption and risk of gastric and pancreatic cancer--a prospective cohort study. Int J Cancer 2012; 132:1651-9. [PMID: 22886387 DOI: 10.1002/ijc.27773] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 07/23/2012] [Indexed: 01/29/2023]
Abstract
Only few prospective studies have examined the association between coffee consumption and risk of gastric and pancreatic cancer. This study is designed to evaluate this relationship among Finns, whose coffee consumption is the highest in the world. A total of 60,041 Finnish men and women who were 26-74 years of age and without history of any cancer at baseline were included in the present analyses. Coffee consumption and other study parameters were determined at baseline using standardized measurements. Participants were prospectively followed up for onset of gastric and/or pancreatic cancer, emigration, death or until June 30, 2006. During a mean follow-up period of 18 years, 299 cases of gastric cancer and 235 cases of pancreatic cancer were found. There was a nonsignificant inverse association between coffee consumption and risk of gastric cancer among men but not in the women. The multivariate-adjusted hazard ratio of stomach and pancreatic cancer incidence for ≥ 10 cups of coffee per day compared with nondrinkers were 0.75 (95% CI, 0.40-1.41) (P for trend = 0.19) and 0.82 (95% CI, 0.38-1.76) (P for trend = 0.95) for the combined population of men and women, respectively. We did not find a significant association between coffee consumption and the risk of gastric and/or pancreatic cancers.
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Affiliation(s)
- Siamak Bidel
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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8
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Lucenteforte E, La Vecchia C, Silverman D, Petersen GM, Bracci PM, Ji BT, Bosetti C, Li D, Gallinger S, Miller AB, Bueno-de-Mesquita HB, Talamini R, Polesel J, Ghadirian P, Baghurst PA, Zatonski W, Fontham E, Bamlet WR, Holly EA, Gao YT, Negri E, Hassan M, Cotterchio M, Su J, Maisonneuve P, Boffetta P, Duell EJ. Alcohol consumption and pancreatic cancer: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). Ann Oncol 2012; 23:374-82. [PMID: 21536662 PMCID: PMC3265544 DOI: 10.1093/annonc/mdr120] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 02/25/2011] [Accepted: 02/28/2011] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heavy alcohol drinking has been related to pancreatic cancer, but the issue is still unsolved. METHODS To evaluate the role of alcohol consumption in relation to pancreatic cancer, we conducted a pooled analysis of 10 case-control studies (5585 cases and 11,827 controls) participating in the International Pancreatic Cancer Case-Control Consortium. We computed pooled odds ratios (ORs) by estimating study-specific ORs adjusted for selected covariates and pooling them using random effects models. RESULTS Compared with abstainers and occasional drinkers (< 1 drink per day), we observed no association for light-to-moderate alcohol consumption (≤ 4 drinks per day) and pancreatic cancer risk; however, associations were above unity for higher consumption levels (OR = 1.6, 95% confidence interval 1.2-2.2 for subjects drinking ≥ 9 drinks per day). Results did not change substantially when we evaluated associations by tobacco smoking status, or when we excluded participants who reported a history of pancreatitis, or participants whose data were based upon proxy responses. Further, no notable differences in pooled risk estimates emerged across strata of sex, age, race, study type, and study area. CONCLUSION This collaborative-pooled analysis provides additional evidence for a positive association between heavy alcohol consumption and the risk of pancreatic cancer.
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Affiliation(s)
- E. Lucenteforte
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
- Department of Occupational Health, University of Milan, Milan, Italy
| | - C. La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
- Department of Occupational Health, University of Milan, Milan, Italy
| | | | | | - P. M. Bracci
- University of California – San Francisco, San Francisco
| | - B. T. Ji
- National Cancer Institute, Bethesda
| | - C. Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
| | - D. Li
- MD Anderson Cancer Center, Houston, USA
| | | | - A. B. Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - H. B. Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - R. Talamini
- Centro di Riferimento Oncologico (CRO) – National Cancer Institute, Aviano (PN), Italy
| | - J. Polesel
- Centro di Riferimento Oncologico (CRO) – National Cancer Institute, Aviano (PN), Italy
| | - P. Ghadirian
- Epidemiology Research Unit, Research Center of the University of Montreal Hospital Centre (CRCHUM), Montreal, Canada
| | - P. A. Baghurst
- Public Health, Women's and Children's Hospital, Adelaide, Australia
| | - W. Zatonski
- Cancer Center & Institute of Oncology, Warsaw, Poland
| | - E. Fontham
- Louisiana State University, New Orleans, USA
| | | | - E. A. Holly
- University of California – San Francisco, San Francisco
| | - Y. T. Gao
- Shanghai Cancer Institute, Shanghai, China
| | - E. Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri” Milan
| | - M. Hassan
- MD Anderson Cancer Center, Houston, USA
| | - M. Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Population Studies and Surveillance, Cancer Care Ontario, Toronto, Canada
| | - J. Su
- National Cancer Institute, Bethesda
| | | | - P. Boffetta
- International Prevention Research Institute, Lyon, France
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, USA
| | - E. J. Duell
- International Agency for Research on Cancer, Lyon, France
- Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
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Genkinger JM, Li R, Spiegelman D, Anderson KE, Albanes D, Bergkvist L, Bernstein L, Black A, van den Brandt PA, English DR, Freudenheim JL, Fuchs CS, Giles GG, Giovannucci E, Goldbohm RA, Horn-Ross PL, Jacobs EJ, Koushik A, Männistö S, Marshall JR, Miller AB, Patel AV, Robien K, Rohan TE, Schairer C, Stolzenberg-Solomon R, Wolk A, Ziegler RG, Smith-Warner SA. Coffee, tea, and sugar-sweetened carbonated soft drink intake and pancreatic cancer risk: a pooled analysis of 14 cohort studies. Cancer Epidemiol Biomarkers Prev 2011; 21:305-18. [PMID: 22194529 DOI: 10.1158/1055-9965.epi-11-0945-t] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Coffee has been hypothesized to have pro- and anticarcinogenic properties, whereas tea may contain anticarcinogenic compounds. Studies assessing coffee intake and pancreatic cancer risk have yielded mixed results, whereas findings for tea intake have mostly been null. Sugar-sweetened carbonated soft drink (SSB) intake has been associated with higher circulating levels of insulin, which may promote carcinogenesis. Few prospective studies have examined SSB intake and pancreatic cancer risk; results have been heterogeneous. METHODS In this pooled analysis from 14 prospective cohort studies, 2,185 incident pancreatic cancer cases were identified among 853,894 individuals during follow-up. Multivariate (MV) study-specific relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models and then pooled using a random-effects model. RESULTS No statistically significant associations were observed between pancreatic cancer risk and intake of coffee (MVRR = 1.10; 95% CI, 0.81-1.48 comparing ≥900 to <0 g/d; 237g ≈ 8oz), tea (MVRR = 0.96; 95% CI, 0.78-1.16 comparing ≥400 to 0 g/d; 237g ≈ 8oz), or SSB (MVRR = 1.19; 95% CI, 0.98-1.46 comparing ≥250 to 0 g/d; 355g ≈ 12oz; P value, test for between-studies heterogeneity > 0.05). These associations were consistent across levels of sex, smoking status, and body mass index. When modeled as a continuous variable, a positive association was evident for SSB (MVRR = 1.06; 95% CI, 1.02-1.12). CONCLUSION AND IMPACT Overall, no associations were observed for intakes of coffee or tea during adulthood and pancreatic cancer risk. Although we were only able to examine modest intake of SSB, there was a suggestive, modest positive association for risk of pancreatic cancer for intakes of SSB.
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Affiliation(s)
- Jeanine M Genkinger
- Mailman School of Public Health, 722 w 168th St, Rm 803, New York, NY 10032, USA.
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10
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Abstract
The clinical outcome of patients with pancreatic cancer remains dismal despite recent advances in diagnostic and therapeutic modalities. Several risk factors have been reported regarding the development of pancreatic cancer. These risk factors include family history, accompanying diseases, and lifestyle/personal habits. Family history includes that of pancreatic cancer and hereditary pancreatic cancer syndrome. Accompanying diseases that increase the risk include diabetes mellitus, obesity, chronic pancreatitis, hereditary pancreatic cancer syndrome and intraductal papillary mucinous neoplasms. Lifestyle-associated factors include smoking and diet. Detailed examination of patients with such risk factors is warranted, but the cost-benefit effect should be considered. Thus, patients with more than one risk factor should be carefully followed up, and periodic examination of such patients is necessary to ensure the detection of smaller and less-advanced pancreatic cancer lesions and thus to improve the clinical outcome of patients with pancreatic cancer.
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Affiliation(s)
- Koji Yamaguchi
- Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health Japan, Yahatanishiku, Kitakyusyu, Japan. yamaguch @ med.uoeh-u.ac.jp
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11
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Yuan JM, Sun C, Butler LM. Tea and cancer prevention: epidemiological studies. Pharmacol Res 2011; 64:123-35. [PMID: 21419224 DOI: 10.1016/j.phrs.2011.03.002] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 03/02/2011] [Indexed: 12/23/2022]
Abstract
Experimental studies have consistently shown the inhibitory activities of tea extracts on tumorigenesis in multiple model systems. Epidemiological studies, however, have produced inconclusive results in humans. A comprehensive review was conducted to assess the current knowledge on tea consumption and risk of cancers in humans. In general, consumption of black tea was not associated with lower risk of cancer. High intake of green tea was consistently associated with reduced risk of upper gastrointestinal tract cancers after sufficient control for confounders. Limited data support a protective effect of green tea on lung and hepatocellular carcinogenesis. Although observational studies do not support a beneficial role of tea intake on prostate cancer risk, phase II clinical trials have demonstrated an inhibitory effect of green tea extract against the progression of prostate pre-malignant lesions. Green tea may exert beneficial effects against mammary carcinogenesis in premenopausal women and recurrence of breast cancer. There is no sufficient evidence that supports a protective role of tea intake on the development of cancers of the colorectum, pancreas, urinary tract, glioma, lymphoma, and leukemia. Future prospective observational studies with biomarkers of exposure and phase III clinical trials are required to provide definitive evidence for the hypothesized beneficial effect of tea consumption on cancer formation in humans.
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Affiliation(s)
- Jian-Min Yuan
- The Masonic Cancer Center, and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 425 East River Road, 554 MCRB, Minneapolis, MN 55455, USA.
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12
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Vrieling A, Bueno-de-Mesquita HB, Boshuizen HC, Michaud DS, Severinsen MT, Overvad K, Olsen A, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Kaaks R, Rohrmann S, Boeing H, Nöthlings U, Trichopoulou A, Moutsiou E, Dilis V, Palli D, Krogh V, Panico S, Tumino R, Vineis P, van Gils CH, Peeters PHM, Lund E, Gram IT, Rodríguez L, Agudo A, Larrañaga N, Sánchez MJ, Navarro C, Barricarte A, Manjer J, Lindkvist B, Sund M, Ye W, Bingham S, Khaw KT, Roddam A, Key T, Boffetta P, Duell EJ, Jenab M, Gallo V, Riboli E. Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer 2010; 126:2394-403. [PMID: 19790196 DOI: 10.1002/ijc.24907] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce. We examined the association of cigarette smoking and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% CI = 1.36-2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% CI = 1.23-2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% CI = 0.96-7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% CI = 1.00-2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.
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Affiliation(s)
- Alina Vrieling
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Gupta S, Wang F, Holly EA, Bracci PM. Risk of pancreatic cancer by alcohol dose, duration, and pattern of consumption, including binge drinking: a population-based study. Cancer Causes Control 2010; 21:1047-59. [PMID: 20349126 PMCID: PMC2883092 DOI: 10.1007/s10552-010-9533-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 03/04/2010] [Indexed: 12/15/2022]
Abstract
Alcohol consumption is postulated to be a risk factor for pancreatic cancer (PCA), but clarification of degree of risk related to consumption characteristics is lacking. We examined the association between alcohol consumption and PCA in a population-based case-control study (532 cases, 1,701 controls) in the San Francisco Bay Area. Population-based controls were frequency-matched by sex, age within 5-year categories and county of residence to cases identified by the cancer registry's rapid case ascertainment. Detailed alcohol consumption data, including binge drinking (>or=5 drinks/day), were collected during in-person interviews. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using adjusted unconditional logistic regression. Depending on dose, duration, and pattern of drinking, ORs were increased 1.5- to 6-fold among men but not women. In men, ORs increased with increasing overall alcohol consumption (22-35 drinks/week OR = 2.2, 95% CI = 1.1-4.0; >or=35 drinks/week OR = 2.6, 95% CI = 1.3-5.1, p-trend = 0.04). Most notable were effects with a history of binge drinking (OR = 3.5, 95% CI = 1.6-7.5) including increased number of drinks per day (p-trend = 0.002), and increased years of binge drinking (p-trend = 0.0006). In fully adjusted models that included smoking and other confounders, ORs for binge drinking in men were somewhat higher than in age-adjusted models. Results from our detailed analyses provide support for heavy alcohol consumption (including binge drinking) as a risk factor for PCA in men.
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Affiliation(s)
- Samir Gupta
- Division of Digestive and Liver Diseases, Harold C Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390-8887, USA.
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Iodice S, Gandini S, Maisonneuve P, Lowenfels AB. Tobacco and the risk of pancreatic cancer: a review and meta-analysis. Langenbecks Arch Surg 2008; 393:535-45. [DOI: 10.1007/s00423-007-0266-2] [Citation(s) in RCA: 374] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Accepted: 11/13/2007] [Indexed: 02/06/2023]
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Pezzilli R, Morselli-Labate AM, Migliori M, Manca M, Bastagli L, Gullo L. Obesity and the risk of pancreatic cancer: an italian multicenter study. Pancreas 2005; 31:221-4. [PMID: 16163052 DOI: 10.1097/01.mpa.0000175163.42327.91] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The purpose of this work was to determine whether obesity is a risk factor for pancreatic cancer. METHODS We studied 400 patients with this tumor and 400 controls matched for sex and age from various Italian cities. We used a standardized questionnaire that was compiled at personal interview, with particular attention to body weight at the time of the interview, and for those with the tumor, their weight before onset of the disease. Body mass index (BMI) was calculated as the patient's weight in kilograms divided by their height in meters squared. RESULTS The risk of pancreatic cancer adjusted for smoking was 5-fold higher (P < 0.001) in patients with a BMI less than 23 kg/m2 after diagnosis compared with patients with a BMI ranging from 23 to 29.9 kg/m2, whereas the risk in patients with BMI of at least 30 kg/m2 was not significant (P = 0.689). Taking into account BMI before diagnosis, smoking was confirmed as a significant risk factor (odds ratio = 1.68; P = 0.001) for pancreatic cancer, whereas no significant relationship was found between BMI classes and the risk of pancreatic cancer (P = 0.984). CONCLUSIONS These findings indicate that obesity is not a risk factor for pancreatic cancer.
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Affiliation(s)
- Raffaele Pezzilli
- Department of Internal Medicine, Sant'Orsola-Malpighi Hospital, Alma Mater Studiorum, Bologna, Italy.
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Burger M, Brönstrup A, Pietrzik K. Derivation of tolerable upper alcohol intake levels in Germany: a systematic review of risks and benefits of moderate alcohol consumption. Prev Med 2004; 39:111-27. [PMID: 15207992 DOI: 10.1016/j.ypmed.2003.11.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The objective of this study is to weigh the risks of moderate alcohol consumption against its benefits and, as a result, to derive tolerable upper alcohol intake levels (TUALs) for the German adult population. METHODS Human studies assessing the effects of moderate alcohol consumption (< or = 40 g/day) on coronary heart disease, stroke, blood pressure, diseases of the liver, gallbladder, bile duct, and pancreas, cancer of the mouth/pharynx/larynx/oesophagus, stomach, colon/rectum, and breast, foetal alcohol syndrome/foetal alcohol effects, as well as all-cause mortality, published in the 10-15 years before 1999, have been systematically reviewed. The quality of studies has been evaluated using a self-constructed evaluation scheme. As a result of comparing the critical endpoints of alcohol intake related to morbidity and mortality, the TUALs have been derived. RESULTS The TUALs have been set at 10-12 g/day for healthy women and 20-24 g/day for healthy men of the adult population (18 years and older). Additional guidelines on alcohol use have been defined, taking into account further important aspects like alcohol consumption patterns and high-risk groups. CONCLUSIONS The TUALs are not intended to be recommended intake levels. However, if the TUALs and the additional guidelines are followed, a relation of alcohol consumption to an increased risk of alcohol-associated diseases is unlikely for the majority of the population.
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Affiliation(s)
- Martina Burger
- Department of Epidemiology and Health Reporting, Robert Koch-Institute, D-13353 Berlin, Germany.
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Gullo L, Migliori M, Falconi M, Pederzoli P, Bettini R, Casadei R, Delle Fave G, Corleto VD, Ceccarelli C, Santini D, Tomassetti P. Nonfunctioning pancreatic endocrine tumors: a multicenter clinical study. Am J Gastroenterol 2003; 98:2435-9. [PMID: 14638345 DOI: 10.1111/j.1572-0241.2003.07704.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Nonfunctioning pancreatic endocrine tumors (NFPTs) are rare neoplasms that have been the object of few studies that have involved only small numbers of patients. This study was carried out to obtain a comprehensive and up-to-date clinical picture of these tumors. METHODS A total of 184 patients with NFPT admitted to three Italian hospitals in the last 15 yr were studied. The diagnosis of NFPT was confirmed histologically using conventional and immunohistochemical techniques. Data were obtained from the medical charts or directly from the patients. RESULTS There were 85 men (46.2%) and 99 women (53.8%). The mean age at diagnosis was 55.2 yr (range 17-82 yr). The percentage of smokers and alcohol drinkers was similar to that in the general population. Seven patients (3.9%) had a family history of exocrine pancreatic carcinoma. In 120 cases (65.2%), the diagnosis was made after workup for pain or other symptoms, in the remaining 64 cases (34.8%), the tumor was discovered incidentally by ultrasound; in this group survival was significantly greater than it was for the symptomatic patients (p=0.0043). Survival was also found to be improved by tumor resection (p<0.0001), absence of metastases (p<0.0001), and small tumor size (< or =3 cm) (p<0.0007). CONCLUSIONS NFPTs were slightly more frequent in women and were diagnosed most often in middle-aged individuals. No risk factors other than a family history of exocrine pancreatic carcinoma were found. Tumor discovery while patients were still asymptomatic, tumor resection, absence of metastases, and tumor size < or =3 cm significantly prolonged survival.
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Affiliation(s)
- Lucio Gullo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
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18
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Affiliation(s)
- Albert B Lowenfels
- Department of Surgery, New York Medical College, Valhalla, NY 10595, USA.
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Lin Y, Tamakoshi A, Kawamura T, Inaba Y, Kikuchi S, Motohashi Y, Kurosawa M, Ohno Y. Risk of pancreatic cancer in relation to alcohol drinking, coffee consumption and medical history: findings from the Japan collaborative cohort study for evaluation of cancer risk. Int J Cancer 2002; 99:742-6. [PMID: 12115510 DOI: 10.1002/ijc.10402] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We evaluated the associations of such lifestyle factors as alcohol drinking, coffee consumption and medical history with risk of death from pancreatic cancer in a large-scale prospective cohort study [the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC study)] in Japan. Subjects were 110,792 (46,465 men and 64,327 women) inhabitants who were enrolled from 45 areas throughout Japan. At baseline, a self-administered questionnaire was used to obtain information on lifestyle factors and medical history. Cox proportional hazard models were used to calculate relative risks. During the follow-up period (mean +/- SD 8.1 +/- 1.8 years), 225 deaths due to pancreatic cancer were identified. Overall, neither alcohol nor coffee intake was associated with risk of death from pancreatic cancer. Heavy coffee consumption (> or =4 cups/day), however, may increase the risk. Men who reported a history of diabetes mellitus and women who reported a history of gallstone/cholecystitis were at significantly (2-fold) increased risk of death from pancreatic cancer.
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Affiliation(s)
- Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan
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Kuper HE, Mucci LA, Trichopoulos D. Coffee, pancreatic cancer and the question of causation. J Epidemiol Community Health 2000; 54:650-1. [PMID: 10942440 PMCID: PMC1731751 DOI: 10.1136/jech.54.9.650] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- H E Kuper
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
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Abstract
Epidemiological studies on the relation between coffee consumption and cancer risk have been mainly focused on cancers of the urinary bladder, pancreas and colorectum. The relation between coffee and bladder cancer is controversial, despite a large number of studies published over the last three decades. In most studies, the risk tends to be higher in coffee drinkers than in those who do not drink coffee, but the excess risk is generally moderate and is neither dose- nor duration-related. Thus, a strong association between coffee drinking and bladder cancer can be excluded, although it is still unclear whether the weak association is causal or nonspecific and due to some bias or confounding. For pancreatic cancer, a possible association with coffee consumption has been postulated in a large case-control study published in 1981; since then, however, most studies have shown no substantial association, and overall evidence suggests that coffee is not materially related to pancreatic cancer risk. Overall evidence on the coffee-colorectal cancer relation suggests an inverse association, since most case-control studies found odds ratios below unity, particularly for colon cancer. The pattern of risk is less clear for cohort studies. A plausible biological explanation has been given in terms of coffee-related reduction of bile acids and neutral sterol secretion in the colon. For other cancer sites, including oral cavity, oesophagus, stomach, liver, breast, ovary, kidney and lymphoid neoplasms, the relation of coffee drinking with cancer risk has been less extensively investigated, but the evidence is largely reassuring.
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Affiliation(s)
- A Tavani
- Istituto di Ricerche Farmacologiche, Mario Negri, Milan, Italy.
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22
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Villeneuve PJ, Johnson KC, Hanley AJ, Mao Y. Alcohol, tobacco and coffee consumption and the risk of pancreatic cancer: results from the Canadian Enhanced Surveillance System case-control project. Canadian Cancer Registries Epidemiology Research Group. Eur J Cancer Prev 2000; 9:49-58. [PMID: 10777010 DOI: 10.1097/00008469-200002000-00007] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The relationship between alcohol, tobacco and coffee consumption and pancreatic cancer was investigated using population-based case-control data obtained from eight Canadian provinces. Our findings are based on analyses performed on 583 histologically confirmed pancreatic cancer cases and 4813 controls. Questionnaire data were obtained directly from 76% of the cases. Male subjects with 35 or more cigarette pack-years had an increased risk of developing pancreatic cancer relative to never smokers (OR= 1.46, 95% CI 1.00-2.14). Similarly, women reporting at least 23 cigarette pack-years of smoking had an odds ratio of 1.84 (95% CI 1.25-2.69). For the most part, consumption of total alcohol, wine, liquor and beer was not associated with pancreatic cancer. Coffee drinking was not related to pancreatic cancer. More work is needed to clarify the role of these and other potentially modifiable risk factors as a means to reduce the incidence of this disease for which treatment results remain disappointing.
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Affiliation(s)
- P J Villeneuve
- Cancer Bureau, Laboratory Centre for Disease Control, Health Protection Branch, Health Canada, Ottawa, Canada.
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23
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Porta M, Malats N, Guarner L, Carrato A, Rifà J, Salas A, Corominas JM, Andreu M, Real FX. Association between coffee drinking and K-ras mutations in exocrine pancreatic cancer. PANKRAS II Study Group. J Epidemiol Community Health 1999; 53:702-9. [PMID: 10656099 PMCID: PMC1756794 DOI: 10.1136/jech.53.11.702] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVE To analyse the relation between coffee consumption and mutations in the K-ras gene in exocrine pancreatic cancer. DESIGN Case-case study. Consumption of coffee among cases with the activating mutation in the K-ras gene was compared with that of cases without the mutation. SETTING AND PATIENTS All cases of pancreatic cancer newly diagnosed at five hospitals in Spain during three years were included in the PANKRAS II Study (n = 185, of whom 121 whose tissue was available for molecular analysis are the object of the present report). Over 88% were personally interviewed in hospital. DNA was amplified from paraffin wax embedded tissues, and mutations in codon 12 of K-ras were detected by the artificial RFLP technique. MAIN RESULTS Mutations were found in tumours from 94 of 121 patients (77.7%). Mutations were more common among regular coffee drinkers than among non-regular coffee drinkers (82.0% v 55.6%, p = 0.018, n = 107). The odds ratio adjusted by age, sex, smoking and alcohol drinking was 5.41 (95% CI 1.64, 17.78). The weekly intake of coffee was significantly higher among patients with a mutated tumour (mean of 14.5 cups/week v 8.8 among patients with a wild type tumour, p < 0.05). With respect to non-regular coffee drinkers, the odds ratio of a mutated tumour adjusted by age, sex, smoking and alcohol drinking was 3.26 for drinkers of 2-7 cups/week, 5.77 for drinkers of 8-14 cups/week and 9.99 for drinkers of > or = 15 cups/week (p < 0.01, test for trend). CONCLUSIONS Pancreatic cancer cases without activating mutations in the K-ras gene had drank significantly less coffee than cases with a mutation, with a significant dose response relation: the less they drank, the less likely their tumours were to harbour a mutation. In exocrine pancreatic cancer the K-ras gene may be activated less often among non-regular coffee drinkers than among regular drinkers. Caffeine, other coffee compounds or other factors with which coffee drinking is associated may modulate K-ras activation.
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Affiliation(s)
- M Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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Lowenfels AB, Maisonneuve P, Lankisch PG. Chronic pancreatitis and other risk factors for pancreatic cancer. Gastroenterol Clin North Am 1999; 28:673-85, x. [PMID: 10503143 DOI: 10.1016/s0889-8553(05)70080-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pancreatic cancer is the fourth or fifth most common form of cancer in Western countries. Early diagnosis is difficult and the overall mortality rate is high. Individuals at high risk for pancreatic cancer include smokers, African-Americans, and persons with various types of pancreatitis. As with other cancers, dietary factors play an important role. Approximately 10% of all pancreatic tumors may be related to an inherited germ line disorder.
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Affiliation(s)
- A B Lowenfels
- Department of Surgery, New York Medical College, Valhalla, USA.
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25
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Stephens FO. The increased incidence of cancer of the pancreas: is there a missing dietary factor? Can it be reversed? THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:331-5. [PMID: 10353546 DOI: 10.1046/j.1440-1622.1999.01567.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
There has been a disturbing increase in the incidence of pancreas cancer, especially in Western countries, during the present century. The only well-established aetiological factor of well-documented significance is the greater incidence of this cancer in tobacco smokers of all communities. Otherwise the reason for the increased incidence is not known but the pattern of increase has some similarities to the increased incidence of breast cancer in women and prostate cancer in men in Western communities. There is now well-documented evidence that the increase in breast and prostate cancers is at least partly related to diet. Typical modern Western diets have a low content of the naturally occurring plant hormones, the phyto-oestrogens, that are still plentiful in traditional diets of Asians and other communities with a low incidence of both breast and prostate cancer. This paper presents evidence to support the hypothesis that the increased incidence of pancreas cancer in Western communities may also be related to the relatively low dietary content and protective qualities of the naturally occurring plant hormones and related compounds. This paper presents evidence to support that hypothesis.
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Affiliation(s)
- F O Stephens
- Department of Surgery, The University of Sydney, The Royal Prince Alfred Hospital, NSW, Australia
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Silverman DT, Swanson CA, Gridley G, Wacholder S, Greenberg RS, Brown LM, Hayes RB, Swanson GM, Schoenberg JB, Pottern LM, Schwartz AG, Fraumeni JF, Hoover RN. Dietary and nutritional factors and pancreatic cancer: a case-control study based on direct interviews. J Natl Cancer Inst 1998; 90:1710-9. [PMID: 9827525 DOI: 10.1093/jnci/90.22.1710] [Citation(s) in RCA: 168] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The relationship between diet and pancreatic cancer remains unclear. In this study, we assessed the role of diet and nutrition as risk factors for pancreatic cancer, using data obtained from direct interviews only, rather than data from less reliable interviews with next of kin. We evaluated whether dietary factors could explain the higher incidence of pancreatic cancer experienced by black Americans compared with white Americans. METHODS We conducted a population-based case-control study of pancreatic cancer diagnosed in Atlanta (GA), Detroit (MI), and 10 New Jersey counties from August 1986 through April 1989. Reliable dietary histories were obtained for 436 patients and 2003 general-population control subjects aged 30-79 years. RESULTS Obesity was associated with a statistically significant 50%-60% increased risk of pancreatic cancer that was consistent by sex and race. Although the magnitude of risk associated with obesity was identical in blacks and whites, a higher percentage of blacks were obese than were whites (women: 38% versus 16%; men: 27% versus 22%). A statistically significant positive trend in risk was observed with increasing caloric intake, with subjects in the highest quartile of caloric intake experiencing a 70% higher risk than those in the lowest quartile. A statistically significant interaction between body mass index (weight in kg/height in m2 for men and weight in kg/height in m1.5 for women) and total caloric intake was observed that was consistent by sex and race. Subjects in the highest quartile of both body mass index and caloric intake had a statistically significant 180% higher risk than those in the lowest quartile. CONCLUSIONS Obesity is a risk factor for pancreatic cancer and appears to contribute to the higher risk of this disease among blacks than among whites in the United States, particularly among women. Furthermore, the interaction between body mass index and caloric intake suggests the importance of energy balance in pancreatic carcinogenesis.
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Affiliation(s)
- D T Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Abstract
Atractyloside (Atr) is a diterpenoid glycoside that occurs naturally in plants (many of which are used in ethnomedicines) found in Europe, Africa, South America, Asia and the far East. It is also present in animal grazing forage. Atr (and its analogues) may be present at levels as high as 600 mg/kg dried plant material. Consumption of the plants containing Atr or carboxyatractyloside (carboxyAtr) has caused fatal renal proximal tubule necrosis and/or centrilobular hepatic necrosis in man and farm animals. Although pure Atr and crude plant extracts disrupt carbohydrate homeostasis and induce similar pathophysiological lesions in the kidney and liver, it is also possible that the toxicity of Atr may be confounded by the presence of other natural constituents in plants. Atr competitively inhibits the adenine nucleoside carrier in isolated mitochondria and thus blocks oxidative phosphorylation. This has been assumed to explain changes in carbohydrate metabolism and the toxic effects in liver and kidney. Although the acute toxicity of Atr is well described, many aspects of Atr toxicity (subchronic and chronic toxicity, reproductive toxicity, mutagenicity and carcinogenicity) have not been investigated and pharmacokinetic and metabolism data are limited. In vitro proximal tubular cells are selectively sensitive to Atr, whereas other renal cell types are quite resistant. There are also differences in the response of liver and renal tissue to Atr. Thus, not all of the clinical, biochemical and morphological changes caused by Atr can simply be explained on the basis of inhibition of mitochondrial phosphorylation. The relevance to a wider human risk is shown by the presence of Atr analogues in dried roasted Coffea arabica beans (17.5 32 mg/kg). There are no data to help identify the risk of low dose chronic exposure in human coffee consumers, nor is there information on the levels of Atr or its analogues in other commonly consumed human foodstuffs.
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Affiliation(s)
- D K Obatomi
- Department of Biochemistry, University of Jos, Nigeria
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Fischbach W, Gross V, Schölmerich J, Ell C, Layer P, Fleig WE. [1997 gastroenterology update--II]. MEDIZINISCHE KLINIK (MUNICH, GERMANY : 1983) 1998; 93:146-64. [PMID: 9564162 DOI: 10.1007/bf03044832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- W Fischbach
- II. Medizinische Klinik, Klinikum Aschaffenburg
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