Original Paper

Cancer Causes & Control

, Volume 18, Issue 8, pp 809-819

Pancreatic cancer and medical history in a population-based case–control study in the San Francisco Bay Area, California

  • Andrew H. KoAffiliated withDivision of Hematology/Oncology, University of California San Francisco
  • , Furong WangAffiliated withDepartment of Epidemiology and Biostatistics, Division of Cancer Epidemiology, School of Medicine, University of California San Francisco
  • , Elizabeth A. HollyAffiliated withDepartment of Epidemiology and Biostatistics, Division of Cancer Epidemiology, School of Medicine, University of California San FranciscoDepartment of Health Research and Policy, School of Medicine, Stanford University Email author 

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Abstract

Objective

To determine the association between pancreatic cancer and medical conditions.

Methods

A large population-based case–control study identified pancreatic cancer cases in the San Francisco Bay Area between 1995 and 1999. A total of 1,701 controls were randomly selected from the same population and were frequency-matched to 532 cases by sex and age. In-person interviews were conducted with no proxy interviews.

Results

Prior history of gallbladder disease was associated with increased risk of pancreatic cancer (OR = 1.6, 95% CI = 1.2–2.2), with the highest risk occurring for gallbladder disease not caused by cholelithiasis (OR = 2.1, 95% CI = 1.1–3.7). Risk was associated with cholelithiasis only for participants diagnosed within the year before their pancreatic cancer (OR = 15, 95% CI = 6.2–34), and for those with cholelithiasis and cholecystectomy within the same time frame (OR = 28, 95% CI = 8.2–96). Gastric and/or duodenal ulcers were associated with increased risk of pancreatic cancer for individuals with ulcers of ≤two years duration (OR = 2.3, 95% CI = 1.1–4.6). Hyperthyroidism (OR = 2.1, 95% CI = 1.0–4.2) and “other” thyroid conditions (OR = 2.2, 95% CI = 1.1–4.2) were associated with increased risk. Participants with at least one first-degree relative with pancreatic cancer had an increased risk (OR = 1.6, 95% CI = 1.1–2.5).

Conclusion

History of recent gallbladder conditions, gastric and/or duodenal ulcers may represent an early manifestation of pancreatic cancer rather than an independent risk factor. These results warrant further investigation in pooled analyses.

Keywords

Pancreatic neoplasms Gallbladder diseases Gastric ulcers Duodenal ulcers Thyroid diseases Case–control studies