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Risk Factors of Familial Pancreatic Cancer in Japan: Current Smoking and Recent Onset of Diabetes

Matsubayashi, Hiroyuki MD, PhD*; Maeda, Atsuyuki MD, PhD; Kanemoto, Hideyuki MD; Uesaka, Katsuhiko MD, PhD; Yamazaki, Kentaro MD; Hironaka, Shuichi MD; Miyagi, Yuji MD§; Ikehara, Hisatomo MD*; Ono, Hiroyuki MD, PhD*; Klein, Alison MD, PhD∥¶; Goggins, Michael MD, PhD∥¶

doi: 10.1097/MPA.0b013e3182156e1b
Original Articles

Objectives: In western countries, 7% to 10% of patients with pancreatic cancer (PC) have a familial predisposition to their disease. The aim of this study was to determine the familial susceptibility to PC in Japan.

Methods: Five hundred seventy-seven patients with PC and 577 age- and gender-matched controls were analyzed for cancer history in their first-degree relative(s) (FDRs) and demographic factors.

Results: The patients with PC were more likely to have an FDR with PC (6.9%) than the controls (2.9%; odds ratio [OR], 2.5; P = 0.02). Three patients (0.5%), but none of the controls, had a family history of PC in multiple FDRs. Smoking, especially current smoking (OR, 1.5; P = 0.005), and diabetes mellitus (OR: 1.7, P = 0.001) were also associated with PC. The odds increased up to 10-fold if the patients were positive for these 3 factors. The patients with familial PC were more likely to be current smokers (40%) and to have diabetes mellitus (32.5%) than the sporadic cases (30.1% and 20.1%; OR, 1.6 and 1.9).

Conclusions: A family history of PC is a risk of PC in Japan (6.9%) as is a personal history of diabetes and smoking. It is prudent to inform the kindred of patients with familiar PC of the risk of smoking and to follow carefully if they develop diabetes.

Abbreviations: PC - pancreatic cancer, FDR - first-degree relative, OR - odds ratio, FPC - familial pancreatic cancer, DM - diabetes mellitus, SIR - standardized incidence rate, IPMN - intraductal papillary mucinous neoplasm, MDCT - multidetector computed tomography, US - ultrasound, NFPTR - National Familial Pancreas Tumor Registry

From the Divisions of *Endoscopy, †Hepato-Biliary-Pancreatic Surgery, ‡Gastrointestinal Oncology, §Center for Cancer Screening, Shizuoka Cancer Center, Shizuoka, Japan; and ∥Departments of Pathology, and ¶Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Baltimore, MD.

Received for publication August 22, 2010; accepted February 11, 2011.

Reprints: Hiroyuki Matsubayashi, MD, PhD, Division of Endoscopy, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan (e-mail:

This study was approved by the institutional review board of Shizuoka Cancer Center.

The authors have no conflict of interest or financial support relevant to this study.

© 2011 Lippincott Williams & Wilkins, Inc.