Alcohol and Tobacco Lower the Age of Presentation in Sporadic Pancreatic Cancer in a Dose-Dependent Manner: A Multicenter Study
Open accessAbstract
OBJECTIVES: The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). METHODS: Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. RESULTS: The median age to diagnosis for PancCa was 66.3 years (95% confidence intervals (CIs), 64.5-68.0). Males were more likely than females to be smokers (77% vs. 69%, P=0.0002) and heavy alcohol and beer consumers (19% vs. 6%, 34% vs. 19%, P<0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95% CI 1.04-2.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95% CI, 1.97-3.68) for active smokers and independent effects for dose (P=0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. CONCLUSIONS: Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.
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The average age for diagnosis of pancreatic cancer is slightly younger in smokers, by several years, than in non-smokers.
“The average age for diagnosis of pancreatic cancer is slightly younger in smokers (by several years) than in non-smokers.”
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- Authors
- Anderson, M. A., Zolotarevsky, E., Cooper, K. L., Sherman, S., Shats, O., Whitcomb, D. C., Lynch, H. T., Ghiorzo, P., Rubinstein, W. S., Vogel, K. J., Sasson, A. R., Grizzle, W. E., Ketcham, M. A., Lee, S.-Y., Normolle, D., Plonka, C. M., Mertens, A. N., Tripon, R. C., & Brand, R. E.
- Affiliations
- Michigan Medicine (US)
- University of Pittsburgh (US)
- University of Nebraska Medical Center (US)
- University of Pittsburgh Medical Center (US)
- Creighton University (US)
- University of Genoa (IT)
- Endeavor Health (US)
- Corresponding author
- Anderson, Michelle A
- ORCID
- Venue
- American Journal of Gastroenterology
- Published
- 2012-11
- Volume
- 107
- Issue
- 11
- Pages
- 1730-1739
- ISSN
- 0002-9270 (ISSN-L)
- PMC
- PMC3923585
- OpenAlex
- W2089544143
- Cited by
- 73
- References
- 40
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 3 · 2015: 11 · 2014: 7 · 2013: 3
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Funders
- National Cancer Institute (R01CA140940, T32CA083654)
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK082097)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- pancreatic ductal adenocarcinoma, age at diagnosis, alcohol consumption, tobacco use, smoking, heavy drinking, beer, dose-response relationship, risk factors, abstinence, family history (medicine), body mass index, sex differences
- MeSH terms
- Adenocarcinoma, Aged, Alcohol Drinking, Female, Humans, Male, Middle Aged, Pancreatic Neoplasms, Prospective Studies, Registries, Risk Factors, Smoking, Body Mass Index, Chi-Square Distribution, Linear Models, Proportional Hazards Models, Age of Onset
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