Serum Immunoglobulin E and Risk of Pancreatic Cancer in
the Prostate, Lung, Colorectal, and Ovarian Cancer
Sara H. Olson1, Meier Hsu1, Joseph L. Wiemels5, Paige M. Bracci5, Mi Zhou5, Joseph Patoka5, William R.
Reisacher4, Julie Wang3, Robert C. Kurtz2, Debra T. Silverman6, and Rachael Z. Stolzenberg-Solomon7
Epidemiologic studies have consistently found that self-reported allergies are associated with reduced risk
of pancreatic cancer. Our aim was to prospectively assess the relationship between serum immunoglobulin E
(IgE), a marker of allergy, and risk. This nested case–control study within the Prostate, Lung, Colorectal, and
Ovarian Cancer Screening Trial (PLCO) included subjects enrolled in 1994 to 2001 and followed through 2010.
There were 283 cases of pancreatic cancer and 544 controls matched on age, gender, race, and calendar date of
blood draw. Using the ImmunoCAP system, we measured total IgE (normal, borderline, elevated), IgE to
(OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. We assessed
Overall, there was no association between the IgE measures and risk. We found a statistically significant
interaction by baseline age: in those aged ?65 years, elevated risks were observed for borderline total IgE (OR,
1.43; 95% CI, 0.88–2.32) and elevated total IgE (OR, 1.98; 95% CI, 1.16–3.37) and positive IgE to food allergens
(OR, 2.83; 95% CI, 1.29–6.20); among participants <65 years, ORs were <1. Other interactions were not
statistically significant. The reduced risk of pancreatic cancer associated with self-reported allergies is not
reflected in serum IgE. Cancer Epidemiol Biomarkers Prev; 23(7); 1414–20. ?2014 AACR.
Pancreatic cancer is a deadly disease, with 5-year sur-
vival only 6% (1). A consistent finding in epidemiologic
studiesisreducedriskassociated withself-reported aller-
gies (2–5). Very little is known about the biologic basis of
For pancreatic cancer, evidence of reduced risk is most
consistent for respiratory allergies, whereas asthma is not
associated with risk. Although few studies have investi-
gated food allergies, there is little evidence of an associ-
ation with risk (3).
Individuals with allergies are characterized by high
levels of serum immunoglobulin E (IgE), both total IgE
be inversely associated with risk of pancreatic cancer; we
did not have a specific hypothesis about IgE to food
allergens. TestsoftotalandspecificIgEmay point toward
a functional allergy pathway that cannot be inferred from
self-reported allergy. We tested this hypothesis in the
National Cancer Institute’s prospective Prostate, Lung,
Colorectal, and Ovarian Cancer Screening Trial (PLCO).
Materials and Methods
We used a nested case–control design within PLCO, a
randomized trial investigating the effects of screening for
prostate, lung, colorectal, and ovarian cancers (6). From
at entry were randomized at 10 screening centers to
receive screening or usual care. Participants were eligible
if they were not currently undergoing treatment for any
cancer (except nonmelanoma skin cancer) and had not
been diagnosed with one of the cancers under study.
Participants completed baseline questionnaires on back-
ground characteristics and provided a blood sample.
Questions on allergies were not included.
Cases had confirmed incident primary pancreatic ade-
nocarcinomas diagnosed from 1994 to 2010 (ICDO3 codes
C250–C259, excluding histology codes for endocrine neo-
2Department of Medicine, Memorial Sloan Kettering Cancer Center;3Divi-
sion of Pediatric Allergy and Immunology, Mt. Sinai Medical Center;
4Department of Otolaryngology-Head and Neck Surgery, Weill Cornell
Medical College, New York, New York;5Department of Epidemiology and
Biostatistics, School of Medicine, University of California, San Francisco,
San Francisco, California;6Occupational andEnvironmental Epidemiology
Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
1Department of Epidemiology and Biostatistics;
7Branch of Nutritional Epidemiology, Division of Cancer
Corresponding Author: Sara H. Olson, 307 East 63rd Street, New York,
NY 10065. Phone: 646-735-8158; Fax: 646-735-0010; E-mail:
?2014 American Association for Cancer Research.
Cancer Epidemiol Biomarkers Prev; 23(7) July 2014
20. Jarvis D, Luczynska C, Chinn S, Potts J, Sunyer J, Janson C, et al.
Change in prevalence of IgE sensitization and mean total IgE with age
and cohort. J Allergy Clin Immunol 2005;116:675–82.
21. Oryszczyn MP, Annesi I, Neukirch F, Dore MF, Kauffmann F. Longi-
tudinal observations of serum IgE and skin prick test response. Am J
Respir Crit Care Med 1995;151:663–8.
Clin Exp Allergy 2002;32:1702–5.
23. Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, et al.
asthma: results from the National Health and Nutrition Examination
Survey 2005–2006. J Allergy Clin Immunol 2010;126:798–806 e13.
24. Sampson HA. Update on food allergy. J Allergy Clin Immunol
2004;113:805–19; quiz 20.
25. Yachida S, Jones S, Bozic I, Antal T, Leary R, Fu B, et al. Distant
metastasis occurs late during the genetic evolution of pancreatic
cancer. Nature 2010;467:1114–7.
Cancer Epidemiol Biomarkers Prev; 23(7) July 2014Cancer Epidemiology, Biomarkers & Prevention
Olson et al.