Alcohol and tobacco lower the age of presentation in sporadic pancreatic cancer in a dose-dependent manner

A multicenter study

Michelle A. Anderson, Eugene Zolotarevsky, Kristine L. Cooper, Simon Sherman, Oleg Shats, David C. Whitcomb, Henry T. Lynch, Paola Ghiorzo, Wendy S. Rubinstein, Kristen J. Vogel, Aaron R. Sasson, William E. Grizzle, Marsha A. Ketcham, Shih Yuan Lee, Daniel Normolle, Caitlyn M. Plonka, Amy N. Mertens, Renee C. Tripon, Randall E. Brand

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). Methods: Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. Results: The median age to diagnosis for PancCa was 66.3 years (95% confidence intervals (CIs), 64.568.0). Males were more likely than females to be smokers (77% vs. 69%, P0.0002) and heavy alcohol and beer consumers (19% vs. 6%, 34% vs. 19%, P0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95% CI 1.042.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95% CI, 1.973.68) for active smokers and independent effects for dose (P0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. Conclusions: Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.

Original languageEnglish (US)
Pages (from-to)1730-1739
Number of pages10
JournalAmerican Journal of Gastroenterology
Volume107
Issue number11
DOIs
StatePublished - Nov 1 2012

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Pancreatic Neoplasms
Multicenter Studies
Tobacco
Alcohols
Adenocarcinoma
Tobacco Use
Age of Onset
Confidence Intervals
Educational Status
Registries
Linear Models
Body Mass Index
Multivariate Analysis
Logistic Models
Smoking
Parturition

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Alcohol and tobacco lower the age of presentation in sporadic pancreatic cancer in a dose-dependent manner : A multicenter study. / Anderson, Michelle A.; Zolotarevsky, Eugene; Cooper, Kristine L.; Sherman, Simon; Shats, Oleg; Whitcomb, David C.; Lynch, Henry T.; Ghiorzo, Paola; Rubinstein, Wendy S.; Vogel, Kristen J.; Sasson, Aaron R.; Grizzle, William E.; Ketcham, Marsha A.; Lee, Shih Yuan; Normolle, Daniel; Plonka, Caitlyn M.; Mertens, Amy N.; Tripon, Renee C.; Brand, Randall E.

In: American Journal of Gastroenterology, Vol. 107, No. 11, 01.11.2012, p. 1730-1739.

Research output: Contribution to journalArticle

Anderson, MA, Zolotarevsky, E, Cooper, KL, Sherman, S, Shats, O, Whitcomb, DC, Lynch, HT, Ghiorzo, P, Rubinstein, WS, Vogel, KJ, Sasson, AR, Grizzle, WE, Ketcham, MA, Lee, SY, Normolle, D, Plonka, CM, Mertens, AN, Tripon, RC & Brand, RE 2012, 'Alcohol and tobacco lower the age of presentation in sporadic pancreatic cancer in a dose-dependent manner: A multicenter study', American Journal of Gastroenterology, vol. 107, no. 11, pp. 1730-1739. https://doi.org/10.1038/ajg.2012.288
Anderson, Michelle A. ; Zolotarevsky, Eugene ; Cooper, Kristine L. ; Sherman, Simon ; Shats, Oleg ; Whitcomb, David C. ; Lynch, Henry T. ; Ghiorzo, Paola ; Rubinstein, Wendy S. ; Vogel, Kristen J. ; Sasson, Aaron R. ; Grizzle, William E. ; Ketcham, Marsha A. ; Lee, Shih Yuan ; Normolle, Daniel ; Plonka, Caitlyn M. ; Mertens, Amy N. ; Tripon, Renee C. ; Brand, Randall E. / Alcohol and tobacco lower the age of presentation in sporadic pancreatic cancer in a dose-dependent manner : A multicenter study. In: American Journal of Gastroenterology. 2012 ; Vol. 107, No. 11. pp. 1730-1739.
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abstract = "Objectives: The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). Methods: Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. Results: The median age to diagnosis for PancCa was 66.3 years (95{\%} confidence intervals (CIs), 64.568.0). Males were more likely than females to be smokers (77{\%} vs. 69{\%}, P0.0002) and heavy alcohol and beer consumers (19{\%} vs. 6{\%}, 34{\%} vs. 19{\%}, P0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95{\%} CI 1.042.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95{\%} CI, 1.973.68) for active smokers and independent effects for dose (P0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. Conclusions: Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.",
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T1 - Alcohol and tobacco lower the age of presentation in sporadic pancreatic cancer in a dose-dependent manner

T2 - A multicenter study

AU - Anderson, Michelle A.

AU - Zolotarevsky, Eugene

AU - Cooper, Kristine L.

AU - Sherman, Simon

AU - Shats, Oleg

AU - Whitcomb, David C.

AU - Lynch, Henry T.

AU - Ghiorzo, Paola

AU - Rubinstein, Wendy S.

AU - Vogel, Kristen J.

AU - Sasson, Aaron R.

AU - Grizzle, William E.

AU - Ketcham, Marsha A.

AU - Lee, Shih Yuan

AU - Normolle, Daniel

AU - Plonka, Caitlyn M.

AU - Mertens, Amy N.

AU - Tripon, Renee C.

AU - Brand, Randall E.

PY - 2012/11/1

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N2 - Objectives: The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). Methods: Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. Results: The median age to diagnosis for PancCa was 66.3 years (95% confidence intervals (CIs), 64.568.0). Males were more likely than females to be smokers (77% vs. 69%, P0.0002) and heavy alcohol and beer consumers (19% vs. 6%, 34% vs. 19%, P0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95% CI 1.042.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95% CI, 1.973.68) for active smokers and independent effects for dose (P0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. Conclusions: Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.

AB - Objectives: The objective of this study was to examine the association between tobacco and alcohol dose and type and the age of onset of pancreatic adenocarcinoma (PancCa). Methods: Prospective data from the Pancreatic Cancer Collaborative Registry were used to examine the association between age of onset and variables of interest including: gender, race, birth country, educational status, family history of PancCa, diabetes status, and tobacco and alcohol use. Statistical analysis included logistic and linear regression, Cox proportional hazard regression, and time-to-event analysis. Results: The median age to diagnosis for PancCa was 66.3 years (95% confidence intervals (CIs), 64.568.0). Males were more likely than females to be smokers (77% vs. 69%, P0.0002) and heavy alcohol and beer consumers (19% vs. 6%, 34% vs. 19%, P0.0001). In univariate analysis for effects on PancCa presentation age, the following were significant: gender, alcohol and tobacco use (amount, status and type), family history of PancCa, and body mass index. Both alcohol and tobacco had dose-dependent effects. In multivariate analysis, alcohol status and dose were independently associated with increased risk for earlier PancCa onset with greatest risk occurring in heavy drinkers (HR 1.62, 95% CI 1.042.54). Smoking status had the highest risk for earlier onset pancreatic cancer with a HR of 2.69 (95% CI, 1.973.68) for active smokers and independent effects for dose (P0.019). The deleterious effects for alcohol and tobacco appear to resolve after 10 years of abstinence. Conclusions: Alcohol and tobacco use are associated with a dose-related increased risk for earlier age of onset of PancCa. Although beer drinkers develop pancreatic cancer at an earlier age than nondrinkers, alcohol type did not have a significant effect after controlling for alcohol dose.

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