Selected medical conditions and risk of pancreatic cancer

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Molecular Carcinogenesis (Impact Factor: 4.81). 01/2012; 51(1):75-97. DOI: 10.1002/mc.20816
Source: PubMed


We review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self-reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long-term pancreatitis, indicating that this condition is both a risk factor and a sign of early disease. Increased risk was reported in association with cholelithiasis, but the few studies that considered time before diagnosis of cancer did not find increased risk for cholelithiasis diagnosed in the more distant past. There is weak evidence that cholecystectomy 2 or more years before cancer diagnosis is related to risk, but this is based on only a few studies. There is no consistent association between ulcers and risk, while gastrectomy may increase risk. Overall, study of these conditions, particularly those that are rare, presents methodologic challenges. Time between diagnoses is likely to be important but is not considered in most studies. Lack of adequate control in several studies for risk factors such as smoking and heavy alcohol use also makes it difficult to draw firm conclusions about these results.

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    • "Furthermore, elevated risk was the highest for recent cholecystectomy (p2 years before cancer diagnosis) but remained statistically significant for remote cholecystectomy (X20 years). Current epidemiologic evidence for associations between selected medical conditions and pancreatic cancer risk is controversial (Olson, 2012). Of 13 studies that have evaluated cholecystectomy and/or gallstones in relation to the occurrence of this malignancy (Lin and Kessler, 1981; Ekbom et al, 1996; Gullo et al, 1996; Chow et al, 1999; Coughlin et al, 2000; Silverman, 2001; Talamini et al, 2001; Ye et al, 2001; Lin et al, 2002; Schernhammer et al, 2002; Stolzenberg-Solomon et al, 2002; Hassan et al, 2007; Lipworth et al, 2011), four studies reported an increased risk for subjects with a history of cholecystectomy (Ekbom et al, 1996; Coughlin et al, 2000; Silverman, 2001; Lin et al, 2002). "
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