Diabetes, gall stone disease, and pancreatic cancer

Norell, Staffan E.; Ahlbom, Anders; Erwald, R; Jacobson, Galia; Lindberg-Navier, I; Olin, Rebecca L.; Wiechel, Karl-Ludvig

doi:10.1038/bjc.1986.185

Cited by 32 publications

(10 citation statements)

References 6 publications

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“…Few studies, however, have considered timing of the cholecystectomy/gallbladder disease in relation to pancreatic cancer. Of the 11 studies indicating a positive association, only four demonstrated an increased pancreatic cancer risk 5 or more years prior to the cancer diagnosis (Norell and Ahlbom, 1986;Hyvarinen and Partanen, 1987;Shibata et al, 1994;Chow et al, 1998), while our study is the first to show an increased risk for subjects with a cholecystectomy at least 20 years prior to the cancer diagnosis, an interval too long to be considered prodromal to pancreatic cancer. A causal relation is further supported by experimental studies showing that cholecystectomy increases circulating levels of cholecystokinin (CCK), which is a major regulator of pancreatic growth and enzyme secretion (Warshaw and Fernandez-del Castillo, 1992), and a promoter of pancreatic carcinogenesis in rodents (Howatson and Carter, 1985;Smith et al, 1990).…”

Section: Discussionmentioning

confidence: 60%

“…Of at least 17 studies conducted to date, 11 have been positive (Wynder et al, 1973;La Vecchia et al, 1980;Lin and Kessler, 1981;Norell and Ahlbom, 1986;Hyvarinen and Partanen, 1987;Cuzick and Babiker, 1989;Kalapothaki et al, 1993;Shibata et al, 1994;Ekbom et al, 1996;Johanson et al, 1996;Chow et al, 1998). Few studies, however, have considered timing of the cholecystectomy/gallbladder disease in relation to pancreatic cancer.…”

Section: Discussionmentioning

confidence: 99%

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Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer

et al. 1999

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In a population-based case-control study of pancreatic cancer conducted in three areas of the USA, 484 cases and 2099 controls were interviewed to evaluate the aetiologic role of several medical conditions/interventions, including diabetes mellitus, cholecystectomy, ulcer/gastrectomy and allergic states. We also evaluated risk associated with family history of cancer. Our findings support previous studies indicating that diabetes is a risk factor for pancreatic cancer, as well as a possible complication of the tumour. A significant positive trend in risk with increasing years prior to diagnosis of pancreatic cancer was apparent ( P -value for test of trend = 0.016), with diabetics diagnosed at least 10 years prior to diagnosis having a significant 50% increased risk. Those treated with insulin had risks similar to those not treated with insulin (odds ratio (OR) = 1.6 and 1.5 respectively), and no trend in risk was associated with increasing duration of insulin treatment. Cholecystectomy also appeared to be a risk factor, as well as a consequence of the malignancy. Subjects with a cholecystectomy at least 20 years prior to the diagnosis of pancreatic cancer experienced a 70% increased risk, which was marginally significant. In contrast, subjects with a history of duodenal or gastric ulcer had little or no elevated risk (OR = 1.2; confidence interval = 0.9–1.6). Those treated by gastrectomy had the same risk as those not receiving surgery, providing little support for the hypothesis that gastrectomy is a risk factor for pancreatic cancer. A significant 40% reduced risk was associated with hay fever, a non-significant 50% decreased risk with allergies to animals, and a non-significant 40% reduced risk with allergies to dust/moulds. These associations, however, may be due to chance since no risk reductions were apparent for asthma or several other types of allergies. In addition, we observed significantly increased risks for subjects reporting a first-degree relative with cancers of the pancreas (OR = 3.2), colon (OR = 1.7) or ovary (OR = 5.3) and non-significantly increased risks for cancers of the endometrium (OR = 1.5) or breast (OR = 1.3). The pattern is consistent with the familial predisposition reported for pancreatic cancer and with the array of tumours associated with hereditary non-polyposis colon cancer. © 1999 Cancer Research Campaign

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer

et al. 1999

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“…However, only some studies have considered the timing of the operation in relation to the development of pancreatic cancer. Only few demonstrated an increased pancreatic cancer risk 5 or more years prior to the cancer diagnosis [28,[54][55][56]. A recent case-control study [28] revealed a 70% excess risk among subjects with cholecystectomy 20 or more years prior to diagnosis of pancreatic cancer, an interval too long to be considered prodromal to pancreatic cancer.…”

Section: Gastrectomy and Cholecystectomy -Risk Factors?mentioning

confidence: 99%

Epidemiological Trends in Pancreatic Neoplasias

Simon

Printz²

2001

Dig Dis

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Primary prevention is the most effective approach to reduce the incidence of pancreatic cancer. Epidemiological studies have contributed to the identification of risk factors for pancreatic cancer, suggesting an association with age, various medical conditions, environmental and lifestyle risk factors, and occupational and genetic conditions. Age is the strongest risk factor. The most consistently identified environmental risk factor is smoking, but there is less certainty concerning dietary factors. Studies have suggested a positive association with high energy intake, cholesterol and meat, while vegetable and fruit intakes are probably protective. Patients with chronic pancreatitis and new onset of diabetes mellitus have a low but increasing risk of having or developing pancreatic cancer. There is strong evidence for the association of hereditary pancreatitis or cystic diseases of the pancreas and pancreatic cancer. A family history of pancreatic cancer is an important risk factor, but only a small proportion can be linked with known familial cancer syndromes. Thus, additional yet unidentified predisposing risk factors have to be assumed

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“…A Swedish case-control study found that high consumption of fried and grilled meat and unsaturated fats (e.g., margarine) was associated with an increased risk, while a high consumption of fruits and vegetables (which contain beta-carotene and vitamin C) was associated with a decreased risk of pancreatic cancer (53). Pancreatic cancer has also been associated with some occupations (54), and with diabetes and gallstone disease (5,55,56).…”

Section: Pancreasmentioning

confidence: 99%