Health status and pancreatic cancer

Czech version

Authors: H. Kollárová ¹; K. Azeem ¹; H. Tomášková ²; V. Procházka ³; Arnošt Martínek ⁴; O. Shonová ⁵; J. Ševčíková ¹; D. Horáková ¹; V. Janout ¹
Authors‘ workplace: Ústav preventivního lékařství, LF UP v Olomouci ¹; Ústav epidemiologie a ochrany veřejného zdraví, LF OU v Ostravě ²; II. interní klinika – gastro-enterologická a hepatologická, FN Olomouc ³; Interní klinika FN Olomouc ⁴; Gastroenterologické oddělení, Nemocnice České Budějovice, a. s. ⁵
Published in: Gastroent Hepatol 2013; 67(2): 154-161
Category: Gastrointestinal Oncology: Original Article

Overview

Introduction:
The Czech Republic ranks among the countries with high incidence and mortality of pancreatic cancer.

Method:
The hospital based case-control study included a total of 529 people (309 pancreatic cancer cases and 220 controls). People in the study came from Olomouc, Ostrava, and Ceske Budejovice (Czech Republic). The relationship between health status (diabetes mellitus, chronic pancreatitis, cholelithiasis), use of medication (aspirin and other anti-inflammatory drugs), the family history (cancer in first-degree relatives), and cancer of the pancreas was studied.

Results:
A positive statistically significant association was found in diabetes mellitus (OR 1.84, 95% CI 1.12–3.03) and pancreatitis (OR 4.10, 95% CI 1.43–11.81). A statistically significant inverse association was found in the use of aspirin (OR 0.33, 95% CI 0.17–0.62) and anti-inflammatory drugs (OR 0.28, 95% CI 0.12–0.65). No association between family history of cancer in first-degree relatives and pancreatic cancer was found.

Conclusion:
Because no specific prevention of pancreatic cancer in the form of an effective screening program exists, it is necessary to pay attention to the factors associated with the disease, such as pancreatitis, diabetes mellitus, and metabolic syndrome, for early detection of pancreatic cancer.

Key words:
pancreatic cancer – health status – analysis

Sources

1. Shikata K, Ninomiya T, Kiyohara Y. Diabetes mellitus and cancer risk: Review of the epidemiological evidence. Cancer Sci 2012; 104(1): 9–14. doi: 10.1111/cas.12043.

2. Dítě P, Geryk E, Jelšíková M et al. How to define people at a high risk of pancreatic cancer. Vnitř Lék 2012; 58(7–8): 195–198.

3. Ben Q, Xu M, Ning X et al. Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. Eur J Cancer 2011; 47(13): 1928–1937.

4. Dušek L, Mužík J, Pavlík T et al. Epidemiologie zhoubných nádorů trávicího traktu v České republice – současný stav a predikce. Gastroenterol Hepatol 2012; 66(5): 331–339.

5. Dušek L, Mužík J, Kubásek M et al. Epidemiologie zhoubných nádorů v České republice [online]. Masarykova univerzita, [2005], [cit. 2012-9-18]. Dostupný z: http://www.svod.cz.

6. Bosetti C, Bertuccio P, Negri E et al. Pancreatic cancer: overview of descriptive epidemiology. Mol Carcinog 2012; 51(1): 3–13.

7. Olson SH, Kurtz RC. Epidemiology of pancreatic cancer and the role of family history. J Surg Oncol 2012; 107(1): 1–7. doi: 10.1002/jso.23149.

8. Pandol S, Gukovskaya A, Edderkaoui M et al. Epidemiology, risk factors, and the promotion of pancreatic cancer: role of the stellate cell. J Gastroenterol Hepatol 2012; 27 (Suppl 2): 127–134.

9. Bracci PM. Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms. Mol Carcinog 2012; 51(1): 53–63.

10. Urayama KY, Holcatova I, Janout V et al. Body mass index and body size in early adulthood and risk of pancreatic cancer in a central European multicenter case-control study. Int J Cancer 2011; 129(12): 2875–2884.

11. Li D, Morris JS, Liu J et al. Body mass index and risk, age of onset, and survival in patients with pancreatic cancer. JAMA 2009; 301(24): 2553–2562.

12. Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 2008; 29(24): 2959–2971.

13. Baranova AV. Adipokine genetics: unbalanced protein secretion by human adipose tissue as a cause of the metabolic syndrome. Genetika 2008; 44(10): 1338–1355.

14. Genkinger JM, Spiegelman D, Anderson KE et al. A pooled analysis of 14 cohort studies of anthropometric factors and pancreatic cancer risk. Int J Cancer 2011; 129(7): 1708–1717.

15. Sovinová H, Sadílek P, Csémy L. Vývoj prevalence kuřáctví v dospělé populaci ČR, názory a postoje občanů ČR k problematice kouření (období 1997–2009). Státní zdravotní ústav 2010. Dostupné z: http://www.szu.cz/uploads/documents/czzp/zavislosti/koureni/Zprava2009DEF.pdf.

16. Lucenteforte E, La Vecchia C, Silverman D et al. Alcohol consumption and pancreatic cancer: a pooled analysis in the International Pancreatic Cancer Case-Control Consortium (PanC4). Ann Oncol 2012; 23(2): 374–382.

17. Tramacere I, Scotti L, Jenab M et al. Alcohol drinking and pancreatic cancer risk: a meta-analysis of the dose-risk relation. Int J Cancer 2010; 126(6): 1474–1486.

18. Stronks K, Van de Mheen H, Van den Bos J et al. The Interrelationship between Income, Health and Employment Status. Int J Epidemiol 1997; 26(3): 592–600.

19. Hsu C, Saif MW. Diabetes and pancreatic cancer. Highlights from the "2011 ASCO Annual Meeting". Chicago, IL, USA; June 3–7, 2011. JOP 2011; 12(4): 330–333.

20. DiMagno EP. Pancreatic cancer: clinical presentation, pitfalls and early clues. Ann Oncol 1999; 10 (Suppl 4): 140–142.

21. Permert J, Larsson J, Westermark GT et al. Islet amyloid polypeptide in patients with pancreatic cancer and diabetes. N Engl J Med 1994; 330(5): 313–318.

22. Schwarts SS, Zeidler A, Moossa AR et al. A prospective study of glucose tolerance, insulin, C-peptide, and glucagon responses in patients with pancreatic carcinoma. Am J Dig Dis 1978; 23(12): 1107–1114.

23. Greer JB, Whitcomb DC. Inflammation and pancreatic cancer: an evidence-based review. Curr Opin Pharmacol 2009; 9(4): 411–418.

24. Jee SH, Ohrr H, Sull JW et al. Fasting serum glucose level and cancer risk in Korean men and women. JAMA 2005; 293(2): 194–202.

25. Gapstur SM, Gann PH, Lowe W et al. Abnormal glucose metabolism and pancreatic cancer mortality. JAMA 2000; 283(19): 2552–2558.

26. Spector SA, Olson ET, Gumbs AA et al. Human insulin receptor and insulin signaling proteins in hepatic disease. J Surg Res 1999; 83(1): 32–35.

27. Chari ST, Leibson CL, Rabe KG et al. Pancreatic cancer-associated diabetes mellitus: prevalence and temporal association with diagnosis of cancer. Gastroenterology 2008; 134(1): 95–101.

28. Gullo L, Pezzilli R, Morselli-Labate AM et al. Diabetes and the risk of pancreatic cancer. N Engl J Med 1994; 331(2): 81–84.

29. Sadeghi N, Abbruzzese JL, Yeung SC et al. Metformin use is associated with better survival of diabetic patients with pancreatic cancer. Clin Cancer Res 2012; 18(10): 2905–2912. doi: 10.1158/1078-0432.CCR-11-2994.

30. Lee MS, Hsu CC, Wahlqvist ML et al. Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer 2011; 11: 20.

31. Egawa N, Tu Y, Sanaka M et al. Family history of diabetes and pancreatic cancer. Pancreas 2005; 30(1): 15–19.

32. Chari ST, Leibson CL, Rabe KG et al. Probability of pancreatic cancer following diabetes: a population-based study. Gastroenterology 2005; 129(2): 504–511.

33. Pannala R, Leibson CL, Rabe KG et al. Temporal association of changes in fasting blood glucose and body mass index with diagnosis of pancreatic cancer. Am J Gastroenterol 2009; 104(9): 2318–2325.

34. Bonelli L, Aste H, Bovo P et al. Exocrine pancreatic cancer, cigarette smoking, and diabetes mellitus: a case-control study in northern Italy. Pancreas 2003; 27(2): 143–149.

35. Tsirambidis JV, Conwell DL, Zuccaro G. Chronic pancreatitis. Med Gen Med 2003; 5(1): 17.

36. Bhanot UK, Moller P. Mechanisms of parenchymal injury and signaling pathways in ectatic ducts of chronic pancreatitis: implications for pancreatic carcinogenesis. Lab Invest 2009; 89(5): 489–497.

37. Chakraborty S, Baine MJ, Sasson AR et al. Current status of molecular markers for early detection of sporadic pancreatic cancer. Biochim Biophys Acta 2011; 1815(1): 44–64.

38. Raimondi S, Lowenfels AB, Morselli-Labate AM et al. Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol 2010; 24(3): 349–358.

39. LaFemina J, Roberts PA, Hung YP et al. Identification of a novel kindred with familial pancreatitis and pancreatic cancer. Pancreatology 2009; 9(3): 273–279.

40. Tavani A, Rosato V, Di Palma F et al. History of cholelithiasis and cancer risk in a network of case-control studies. Ann Oncol 2012; 23(8): 2173–2178.

41. Kollárová H, Janoutová G, Foretová L et al. The risk factors of pancreatic cancer (Rizikové faktory karcinomu pankreatu). Klin Onkol 2006; 6: 287–289.

42. Landi S. Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature. Mutat Res 2009; 681(2–3): 299–307.

43. Schernhammer ES, Kang JH, Chan AT et al. A prospective study of aspirin use and the risk of pancreatic cancer in women. J Natl Cancer Inst 2004; 96(1): 22–28.

44. Larsson SC, Håkansson N, Giovannucci E et al. Folate intake and pancreatic cancer incidence: a prospective study of Swedish women and men. J Natl Cancer Inst 2006; 98(6): 407–413.

45. Bradley MC, Hughes CM, Cantwell MM et al. Non-steroidal antiinflammatory drugs and pancreatic cancer risk: a nested case-control study. Br J Cancer 2010; 102(9): 1415–1421.

46. Holly EA, Chaliha I, Bracci PM et al. Signs and symptoms of pancreatic cancer: a population-based case-control study in the San Francisco Bay area. Clin Gastroenterol Hepatol 2004; 2(6): 510–517.

47. Canto MI, Goggins M, Hruban RH et al. Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol 2006; 4(6): 766–781.

48. Hucl T. Karcinom pankreatu (Pancreatic cancer). Gastroent Hepatol 2012; 66(5): 350–356.

49. Klein AP, Brune KA, Petersen GM et al. Prospective risk of pancreatic cancer in familial pancreatic cancer kindreds. Cancer Res 2004; 64(7): 2634–2638.

50. Brat DJ, Lillemoe KD, Yeo CJ et al. Progression of pancreatic intraductal neoplasias to infiltrating adenocarcinoma of the pancreas. Am J Surg Pathol 1998; 22(2): 163–169.

51. Canto MI, Hruban RH, Fishman EK et al. Frequent detection of pancreatic lesions in asymptomatic high-risk individuals. Gastroenterology 2012; 142(4): 796–804.