International Journal of Epidemiology, 2018, Vol. 47, No. 4 1357 International Journal of Epidemiology, 2018, 1357 Variation of the age at onset of doi: 10.1093/ije/dyy082 Advance Access Publication Date: 23 May 2018 pancreatic cancer according to tobacco smoking and family history 1 2 Patrick Maisonneuve * and Albert B. Lowenfels 1 2 Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy and Department of Surgery and Department of Family Medicine, New York Medical College, Valhalla, NY, USA *Corresponding author. Division of Epidemiology and Biostatistics, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy. E-mail: email@example.com We congratulate the authors of the recent paper reporting earlier in current smokers than never-smokers (63.6 vs on the association between pancreatic cancer (PC) in 68.6 years; P< 0.001). patients with a positive family history of cancer. They used It would be very informative if the PanGenEU study an original study design allowing them to better characterize investigators could provide information on the age at the association between family history of PC (FHPC), fami- development of PC by smoking status and FHPC in their lial aggregation of other cancer, family history of diabetes study. They have a unique setting in which to assess and PC risk. They reported that the risk of PC associated whether smoking anticipates the development of PC in with FHPC was higher among ever-smokers [odds ratio those with a positive FHPC. This would provide further (OR)¼ 3.16; 95% confidence interval (CI): 2.56–5.78], information to help identify subgroups of the population particularly in those with two or more first-degree relatives among whom screening or surveillance programmes could affected with PC (OR¼ 5.41; 95% CI: 4.16–18.77). be reasonably considered, and would help in deciding at In an earlier nested case-control study set up in familial which age prevention should be initiated. pancreatic cancer kindreds, smoking has been shown to be an independent risk factor for familial PC (OR¼ 3.7; 95% References CI: 1.8–7.6). In that study, smokers developed cancer one 1. Molina-Montes E, Gomez-Rubio P, Ma ´ rquez M et al.; PanGenEU decade earlier than non-smokers (59.6 vs 69.1 years; Study Investigators. Risk of pancreatic cancer associated with P¼ 0.01). In a cohort of patients with hereditary pancrea- family history of cancer and other medical conditions by account- titis, which is associated with a very high risk of PC, smok- ing for smoking among relatives. Int J Epidemiol ing has been associated with an approximately 2-fold 2018;47:473–83. 2. Rulyak SJ, Lowenfels AB, Maisonneuve P et al. Risk factors for (OR¼ 2.1; 95% CI: 0.7–6.1) increased risk of PC, similar the development of pancreatic cancer in familial pancreatic cancer to that observed in the general population, but PC devel- kindreds. Gastroenterology 2003;124:1292–99. oped 20 years earlier in smokers than in non-smokers 3. Lowenfels AB, Maisonneuve P, Whitcomb DC, Lerch MM, (50 vs 70 years; P¼ 0.02) in this highly susceptible popula- DiMagno EP. Cigarette smoking as a risk factor for pancreatic tion. Other studies also suggest that smoking lowers the cancer in patients with hereditary pancreatitis. JAMA age of onset of sporadic PC. Using prospective data from 2001;286:169–70. 4. Anderson MA, Zolotarevsky E, Cooper KL et al. Alcohol and the Pancreatic Cancer Collaborative Registry, Anderson 4 tobacco lower the age of presentation in sporadic pancreatic can- et al. found that those smoking more than a pack of ciga- cer in a dose-dependent manner: a multicenter study. Am J Gas- rettes per day presented with PC almost 6 years earlier troenterol 2012;107:1730–39. than non-smokers (63.8 vs 69.5 years; P¼ 0.0002). And in 5. Mizuno S, Nakai Y, Isayama H et al. Smoking, family history of can- a retrospective case series from Japan, Mizuno et al. also cer, and diabetes mellitus are associated with the age of onset of pan- found that the onset of sporadic PC occurred somewhat creatic cancer in Japanese patients. Pancreas 2014;43:1014–17. V The Author 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
International Journal of Epidemiology – Oxford University Press
Published: Aug 1, 2018
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