Using the Risk Factors of Pancreatic Cancer and Their Interactions in Cancer Screening: A Case-Control Study in Shanghai, China

Xiaojie Bo; Jianwei Shi; Rui Liu; Shasha Geng; Qingqing Li; Yang Li; Hua Jin; Sen Yang; Hua Jiang; Zhaoxin Wang

doi:10.5334/aogh.2463

Using the Risk Factors of Pancreatic Cancer and Their Interactions in Cancer Screening: A Case-Control Study in Shanghai, China

Ann Glob Health. 2019 Jul 11;85(1):103. doi: 10.5334/aogh.2463.

Authors

Xiaojie Bo¹, Jianwei Shi^{2

3}, Rui Liu¹, Shasha Geng⁴, Qingqing Li⁴, Yang Li⁴, Hua Jin^{2

5

6}, Sen Yang^{2

5

6}, Hua Jiang⁴, Zhaoxin Wang^{1

2}

Affiliations

¹ Department of Pediatrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, CN.
² School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, CN.
³ Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, CN.
⁴ Shanghai East Hospital, Tongji University School of Medicine, Shanghai, CN.
⁵ Academic Department of General Practice, Tongji University School of Medicine, Shanghai, CN.
⁶ Shanghai General Practice and Community Health Development Research Center, Shanghai, CN.

Abstract

Background: The incidence of pancreatic cancer has increased annually, but the risk factors and their interactions are still unknown.

Objective: The aim of this study was to identify risk factors and the effects of their interactions on pancreatic cancer occurrence among patients in Shanghai, China.

Methods: We conducted a hospital-based case-control study. The case group consisted of pathologically diagnosed pancreatic cancer patients, and the control group consisted of a healthy population. The Pearson Chi-square test was used to compare the distribution frequencies of data between groups. Multivariate analysis and interaction analysis were conducted to explore possible risk factors and interactions between various variables.

Findings: Among the 4,821 recruited participants, 1,392 were pancreatic cancer patients and 3,429 were controls. Multivariate logistic analysis suggested that age (>50 years old) (AOR: 16.20 [95% CI 6.78; 38.69]), diabetes (AOR: 5.40 [95% CI 2.70; 10.80]), chronic pancreatitis (AOR: 27.43 [95% CI 2.14; 351.77]), smoking (AOR: 8.86 [95% CI 3.07; 25.58]), and family cancer history (AOR: 2.10 [95% CI 1.09; 8.56]) were the primary risk factors for pancreatic cancer. Interestingly, synergistic interactions between risk factors were found, especially between age and chronic pancreatitis (RERI = 447.93, API = 96.74%, SI = 32.78), age and smoking (RERI = 187.42, API = 94.97%, SI = 21.99), and diabetes and smoking (RERI = 14.39, API = 48.06%, SI = 1.99).

Conclusions: Age, diabetes, chronic pancreatitis, smoking, and family cancer history have been verified as the primary risk factors for pancreatic cancer in this study. Moreover, the interaction effects between old age, diabetes, chronic pancreatitis, and smoking substantially increase the probability of the development of pancreatic cancer. Cancer screening should be conducted extensively among people with these multiple factors to improve the efficiency.

© 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
China / epidemiology
Diabetes Mellitus / epidemiology
Early Detection of Cancer*
Family Health
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms / diagnosis*
Pancreatic Neoplasms / epidemiology*
Pancreatitis, Chronic / epidemiology
Risk Factors
Smoking / epidemiology
Young Adult

Grants and funding

The design of this study involving some previous investigations was supported by the Key Developing Disciplines of Shanghai Municipal Commission of Health and Family Planning (2015ZB0602). Data extraction was financially funded by the Natural Science Foundation of China (71774116). The analysis and interpretation of the data guided by statisticians were funded by the Soft Projects of Shanghai Municipal Commission of Science and Technology (17692105200), and the writing and revision, including the language editing, were supported by the Surface Project of Shanghai Municipal Commission of Health and Family Planning (201740202) and the Shanghai Excellent Young Talents Project in Health System (2018YQ52), National Natural Science Foundation of China (71603182), National Natural Science Foundation of China (71804128).