An Absolute Risk Model to Identify Individuals at Elevated Risk for Pancreatic Cancer in the General Population
Open accessAbstract
PURPOSE: We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer. PATIENTS AND METHODS: Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estimated absolute risks based on these relative risks and population incidence rates. RESULTS: Our risk model included current smoking (multivariable adjusted odds ratio (OR) and 95% confidence interval: 2.20 [1.84-2.62]), heavy alcohol use (>3 drinks/day) (OR: 1.45 [1.19-1.76]), obesity (body mass index >30 kg/m(2)) (OR: 1.26 [1.09-1.45]), diabetes >3 years (nested case-control OR: 1.57 [1.13-2.18], case-control OR: 1.80 [1.40-2.32]), family history of pancreatic cancer (OR: 1.60 [1.20-2.12]), non-O ABO genotype (AO vs. OO genotype) (OR: 1.23 [1.10-1.37]) to (BB vs. OO genotype) (OR 1.58 [0.97-2.59]), rs3790844(chr1q32.1) (OR: 1.29 [1.19-1.40]), rs401681(5p15.33) (OR: 1.18 [1.10-1.26]) and rs9543325(13q22.1) (OR: 1.27 [1.18-1.36]). The areas under the ROC curve for risk models including only non-genetic factors, only genetic factors, and both non-genetic and genetic factors were 58%, 57% and 61%, respectively. We estimate that fewer than 3/1,000 U.S. non-Hispanic whites have more than a 5% predicted lifetime absolute risk. CONCLUSION: Although absolute risk modeling using established risk factors may help to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors.
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An artificial neural network model using US National Health Interview Survey and PLCO Trial data reached an AUC of 0.85 and included age, sex, race and ethnicity, diabetes, emphysema, asthma, stroke, cardiovascular diseases, ulcers, other cancer, hypertension, smoking status, physical activity, alcohol consumption, and family history of pancreatic ductal adenocarcinoma.
“This model reached an AUC of 0·85 and incorporated data on age, sex, race and ethnicity, diabetes, emphysema, asthma, stroke, cardiovascular diseases, ulcers, other cancer, hypertension, smoking status, physical activity, alcohol consumption, and family history of pancreatic ductal adenocarcinoma.”
From Early detection of pancreatic cancer (2020) · cites this paper as [110]
Medical imaging has been shown to detect precancerous tissue changes in the pancreas among individuals at high risk.
“The ability to detect precancerous tissue changes in the pancreas using medical imaging among individuals at high risk has also been shown.110,122–125”
From Early detection of pancreatic cancer (2020) · cites this paper as [110]
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References 50 · Cited by 148
Research works printed but not linked: 3
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- Authors
- Klein, A. P., Lindström, S., Mendelsohn, J. B., Steplowski, E., Arslan, A. A., Bueno-de-Mesquita, H. B., Fuchs, C. S., Gallinger, S., Gross, M., Helzlsouer, K., Holly, E. A., Jacobs, E. J., LaCroix, A., Li, D., Mandelson, M. T., Olson, S. H., Petersen, G. M., Risch, H. A., Stolzenberg-Solomon, R. Z., Zheng, W., Amundadottir, L., Albanes, D., Allen, N. E., Bamlet, W. R., Boutron-Ruault, M.-C., Buring, J. E., Bracci, P. M., Canzian, F., Clipp, S., Cotterchio, M., Duell, E. J., Elena, J., Gaziano, J. M., Giovannucci, E. L., Goggins, M., Hallmans, G., Hassan, M., Hutchinson, A., Hunter, D. J., Kooperberg, C., Kurtz, R. C., Liu, S., Overvad, K., Palli, D., Patel, A. V., Rabe, K. G., Shu, X.-O., Slimani, N., Tobias, G. S., Trichopoulos, D., Van Den Eeden, S. K., Vineis, P., Virtamo, J., Wactawski-Wende, J., Wolpin, B. M., Yu, H., Yu, K., Zeleniuch-Jacquotte, A., Chanock, S. J., Hoover, R. N., Hartge, P., & Kraft, P.
- Affiliations
- Johns Hopkins University (US)
- Harvard University (US)
- National Institutes of Health (US)
- Information Management Services (US)
- New York University (US)
- University Medical Center Utrecht (NL)
- Brigham and Women's Hospital (US)
- University of Minnesota (US)
- Mercy Medical Center (US)
- University of California, San Francisco (US)
- American Cancer Society (US)
- Fred Hutch Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- Group Health Cooperative (US)
- Memorial Sloan Kettering Cancer Center (US)
- Mayo Clinic (US)
- Yale University (US)
- Vanderbilt University (US)
- University of Oxford (GB)
- German Cancer Research Center (DE)
- University of Toronto (CA)
- Institut d'Investigació Biomédica de Bellvitge (ES)
- Umeå University (SE)
- National Cancer Institute (US)
- University of California, Los Angeles (US)
- Aarhus University (DK)
- Istituto per lo Studio e la Prevenzione Oncologica (IT)
- Centre international de recherche sur le cancer (FR)
- Imperial College London (GB)
- Finnish Institute for Health and Welfare (FI)
- Corresponding author
- Klein, Alison P.
- ORCID
- Klein, Alison P.
- Lindström, Sara
- Arslan, Alan A.
- Fuchs, Charles S.
- Holly, Elizabeth A.
- Jacobs, Eric J.
- LaCroix, Andrea
- Li, Donghui
- Olson, Sara H.
- Petersen, Gloria M.
- Risch, Harvey A.
- Zheng, Wei
- Amundadottir, Laufey
- Albanes, Demetrius
- Allen, Naomi E.
- Bamlet, William R.
- Buring, Julie E.
- Bracci, Paige M.
- Canzian, Federico
- Cotterchio, Michelle
- Duell, Eric J.
- Elena, Joanne
- Gaziano, J. Michael
- Giovannucci, Edward L.
- Goggins, Michael
- Hassan, Manal
- Hutchinson, Amy
- Kooperberg, Charles
- Kurtz, Robert C.
- Liu, Simin
- Overvad, Kim
- Palli, Domenico
- Patel, Alpa V.
- Rabe, Kari G.
- Shu, Xiao-Ou
- Slimani, Nadia
- Tobias, Geoffrey S.
- Vineis, Paolo
- Wolpin, Brian M.
- Yu, Herbert
- Yu, Kai
- Chanock, Stephen J.
- Hoover, Robert N.
- Kraft, Peter
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-09-13
- Volume
- 8
- Issue
- 9
- Pages
- e72311
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3772857
- OpenAlex
- W1998964655
- Cited by
- 148
- References
- 50
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 19 · 2022: 13 · 2021: 12 · 2020: 9 · 2019: 8 · 2018: 8 · 2017: 9 · 2016: 15 · 2015: 18 · 2014: 10 · 2013: 1
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
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- Europe PMC (PubMed Central) (publishedVersion, other-oa)
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- U.S. Department of Health and Human Services (42129‐32, 42107-26, 32108‐9, 32118-32119, P50CA127003, HL043851, CA127003, 32115, 32100‐2, HHSN261200800001E, CA34944, HL34595, CA40360, CA047988, P01 CA87969, 44221, R37 CA70867, 32105‐6, ES000260, HL26490, 32122, 24152, N01-WH-2-2110, P30CA016087, HL080467)
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- State of Connecticut Department of Public Health
- Yale University
- Lustgarten Foundation (P50CA62924)
- Memorial Sloan-Kettering Cancer Center
- University of Minnesota (HHSN261200800001E)
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- Georgetown University (NO1-CN-25522)
- Deutsches Krebsforschungszentrum (RD06/0020, P01 CA87969)
- Wellcome Trust (P01 CA87969)
- Pancreatic Cancer Canada Foundation
- Cancer Research UK (RD06/0020, 25514, P01 CA87969)
- National Institute for Health and Care Research
- British Heart Foundation
- European Commission (RD06/0020, 75022, P01 CA87969)
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- Hellenic Health Foundation (P01 CA87969, RD06/0020)
- National Institutes of Health (n01cn025516-044, n01cn025515-047, n01cn025513-043, CA 34944, n01cn025404-013, n01cn025514-038, 5r01ca098870-06, N01-RC- 45035, n01cn025511-041, n01cn025524-036, 32122, Contract No. HHSN261200800001E., N01RC37004, n01rc37004-9-0-0, n01cn075022-017, n01cn025476-008, 32108‐9, 42129‐32, n01cn025522-043, n01cn025512-050, n01cn045165-030, #HHSN261200800001E, 42107–26, 5k07ca073790-05, n01wh22110-38-0-0, n01cn025518-039, 32118-32119, 44221, 32115, 32100‐2, HHSN261200800001C, RD06/0020, 5r01hl043851-10, N01 RC037004, N01-WH-2-2110, 24152, HL-043851, N01 WH022110, CA127003, CA102701, P01 CA 55075, ES000260, CA 87969, CA55075, 5R01CA098870, N01-CN-45165, HL-26490, 32105-6)
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- University of Texas MD Anderson Cancer Center
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- University of Colorado Denver (NO1-CN-25514)
- Medical Research Council (RD06/0020, P01 CA87969)
- World Cancer Research Fund (P01 CA87969, RD06/0020)
- Instituto de Salud Carlos III (RD06/0020)
- National Institute on Aging (U01AG018033)
- National Heart, Lung, and Blood Institute (R01HL080467, HL-34595, HL043851, 32100‐2, 32118‐32119, HL 26490, N01‐WH‐22110, 32118, R01‐HL043851, R01 HL26490, 42107‐26, R01 HL34595, 32119, 24152, 32105–6, R01 HL026490, 32108‐9, 32115, HHSN261200800001E, HL080467, 42129‐32, R01HL034595, CA55075, 32122, CA047988, CA87969, 44221)
- National Cancer Institute (CA97193, R01-CA82729, P50CA127003, N01 CN25514, CA 108370, HL-080467, N01 CN025511, N01-CN25404, R01CA040360, N01-CN-25 522, No. HHSN261200800001E, N01 CN-25524, CA-73790, CA102701, R01CA105069, ES 000260, R01 CA098870, R01CA124908, P01 CA 55075, R01CA-97075, CA109767, K07CA140790, N01-CN-25 476, R01 CA34944, N01 CN25515, Contract No.,HHSN261200800001E, R01 CA98380, CA-87969, R37CA070867, R03CA089726, N01 CN025516, R01CA109767, HL-043851, R01CA154823, R03CA108370, CA-55075, P50CA-62924, N01 CN025515, CA127003, HHSN261200800001E), P01CA087969, N01 CN025514, 5R01CA098870, R01CA098661, CA 34944, R01 CA034944, R01CA059706, RD06/0020, N01CN25511, R01CA098380, N01 CN025522, R01CA082729, UM1CA173640, R01CA097193, P50CA102701, CA 047988, CA 40360, R01CA034588, R37-CA70867, N01 CN045165, CA 70867, N01 CN025476, CA89726, CA105069, N01 CN025404, CA124908, N01 CN 45165, CA59706, N01CN75022, R01CA097075, R01CA098889, P01CA055075, N01 CN025518, N01 CN025512, N01 CN025513, N01WH22110, R01CA047988, CA98380, CA98889, N01 CN075022, R01 CA97193, P50CA062924, N01-CN-25513, N01 CN025524, R01CA40360, [P01 CA87969, P30CA008748, P30CA016087, N01 CN25512, N01CN25518, N01-CN-25 516)
- National Institute of Environmental Health Sciences (ES-000260, RD06/0020, HHSN261200800001E, P30ES000260, P01 CA87969)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Keywords
- pancreatic cancer, risk prediction, smoking, alcohol consumption, obesity, diabetes mellitus, family history (medicine), ABO blood group system, genetic risk variants, lifetime risk, European ancestry, non-Hispanic whites
- MeSH terms
- ABO Blood-Group System, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Europe, Female, Genotype, Humans, Male, Middle Aged, Pancreatic Neoplasms, Risk Factors, ROC Curve, Smoking, United States, Models, Statistical, Odds Ratio, Case-Control Studies, White People, Diabetes Complications
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