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Lifestyle, Occupational, and Reproductive Factors in Relation to Pancreatic Cancer Risk

Lo, An-Chi MPH*; Soliman, Amr S. MD, PhD*; El-Ghawalby, Nabih MD; Abdel-Wahab, Mohamed MD; Fathy, Omar MD; Khaled, Hussein M. MD; Omar, Sherif MD; Hamilton, Stanley R. MD§; Greenson, Joel K. MD; Abbruzzese, James L. MD

doi: 10.1097/mpa.0b013e318053e7d3
Original Articles

Objectives: This study examined the epidemiology of pancreatic cancer in Egypt.

Methods: We obtained detailed information on smoking, occupational, medical, and reproductive histories from 194 pancreatic cancer cases and 194 controls.

Results: Compared with not smoking, smoking cigarettes alone or in conjunction with other smoking methods (eg, water pipe, cigar) was associated with an increased risk (odds ratio [OR], 4.5 and 7.8; 95% confidence interval [95% CI], 1.9-10.7 and 3.0-20.6, respectively). Passive smoking was also a significant risk factor (OR, 6.0; 95% CI, 2.4-14.8). The risk of pancreatic cancer was elevated among subjects exposed to pesticides (OR, 2.6; 95% CI, 0.97-7.2). A prior diagnosis of diabetes mellitus for a period of 10 years was associated with higher risk (OR, 5.4; 95% CI, 1.5-19.9). For women, having 7 or more live births and lactating for 144 months or longer were associated with a reduced risk (OR, 0.5 and 0.2; 95% CI, 0.2-1.3 and 0.1-0.9, respectively). No association was found between family history, allergy, or obesity and pancreatic cancer in Egypt.

Conclusions: Multiple tobacco consumption methods, passive smoking, pesticide exposures, and diabetes are associated with an increased risk for pancreatic cancer. Prolonged lactation and increased parity are associated with a reduced risk for pancreatic cancer.

From the *Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI; †The Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt; ‡The National Cancer Institute, Cairo University, Cairo, Egypt; §Division of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX; ∥Department of Pathology, University of Michigan College of Medicine, Ann Arbor, MI; and ¶Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.

Received for publication September 26, 2006; accepted February 27, 2007.

This study was supported by grants CA K07 090241, R03 CA099513, and R03 CA113750 and the University of Michigan's Cancer Center Support Grant (5 P30 CA46592) from the National Cancer Institute.

Reprints: Amr S. Soliman, MD, PhD, Department of Epidemiology, University of Michigan School of Public Health, 109 Observatory, Ann Arbor, MI 48109 (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.