Cigarette, cigar and pipe smoking, passive smoke exposure, and risk of pancreatic cancer: a population-based study in the San Francisco Bay Area

Exposure data were collected during in-person interviews in a population-based case-control study of pancreatic cancer (N = 532 cases, N = 1701 controls) in the San Francisco Bay Area. Odds ratios (ORs) were adjusted for potential confounders.The adjusted odds ratio (OR) of pancreatic cancer among current smokers was 1.9 (95% confidence interval (CI), 1.4-2.7). A significant, positive trend in risk with increasing pack-years of smoking was observed (P-trend <0.0001). Compared with participants who continued to smoke, former smokers had no statistically significant elevation in risk of pancreatic cancer 10 years after smoking cessation, with risk reduced to that of never smokers regardless of prior smoking intensity. Both men and women experienced similar increased risk of pancreatic cancer with increasing smoking duration. Cigar and pipe smoking and exposure to passive smoke were not associated with pancreatic cancer.Cigarette smoking is associated with an increased risk of pancreatic cancer. Smokers who had quit for ≥10 years no longer experienced an increased risk. Future work will help to determine the effect of declining smoking rates on pancreatic cancer incidence.Pancreatic cancer is the fourth leading cause of death from cancer among men and women in the United States and is expected to result in 43,140 new cases and 36,800 deaths in 2010 [1]. Due to its aggressiveness and a lack of early detection methods, pancreatic cancer is often metastatic in patients at the time of diagnosis resulting in a 5-year relative survival rate for all stages of <5%. The incidence of pancreatic cancer varies by age, sex, and race - and survival differences by race have been observed [2-6].Of the several modest risk factors that have been identified for pancreatic cancer, including obesity, diabetes, physical inactivity, chronic pancreatitis and dietary factors [7-12], cigarette smoking has been reported most consistently [2,13-17]. In a large meta-analysis [14] current cigarette