Diabetes type II, other medical conditions and pancreatic cancer risk: a prospective study in The Netherlands

• Published in: British journal of cancer 2013-11, Vol.109 (11), p.2924-2932
• Main Authors: Eijgenraam, P, Heinen, M M, Verhage, B A J, Keulemans, Y C, Schouten, L J, van den Brandt, P A
• Format: Article
• Language: English
• Subjects: 692/499; 692/699; 692/699/67/1504/1713; 692/699/67/2324; Aged; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Cohort Studies; Comorbidity; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Drug Resistance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Netherlands - epidemiology; Oncology; Pancreatic cancer; Pancreatic Neoplasms - epidemiology; Prospective Studies; Risk Factors; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.629

Background: To date, only a few risk factors for pancreatic cancer have been established. We examined prospectively relations between several medical conditions and pancreatic cancer incidence. Methods: In 1986, 120 852 participants completed a baseline questionnaire on cancer risk factors, including several self-reported physician diagnosed medical conditions. At baseline, a random subcohort of 5000 participants was selected using a case-cohort approach for analysis. After 16.3 years of follow-up, 448 pancreatic cancer cases (63% microscopically confirmed) were available for analysis. Results: Diabetes mellitus type II and hepatitis were positively associated with pancreatic cancer risk (multivariable-adjusted hazard ratio: 1.79; 95% confidence interval: 1.12–2.87 and hazard ratio: 1.37; 95% confidence interval: 1.04–1.81, respectively). Furthermore, a positive trend in risk with increasing years of diagnosis of diabetes ( P =0.004) and of hepatitis ( P =0.02) was observed. However, an inverse association was observed between hypertension and pancreatic cancer risk, this was found among microscopically confirmed cases only (hazard ratio: 0.66; 95% confidence interval: 0.49–0.90), while years since diagnosis of hypertension significantly decreased cancer risk (P for trend=0.02). Conclusion: In this prospective study, a positive association was observed between self-reported physician diagnosed diabetes mellitus type II and hepatitis and pancreatic cancer risk, whereas an inverse association was observed with hypertension.