A novel scoring system to analyze combined effect of lifestyle factors on pancreatic cancer risk: a retrospective case-control study

Xiaofei Zhang,Tianshu Pang,Zhengrong Wu,Guoping Ding,Guixing Jiang,Yifei Yang,Liping Cao

doi:10.1038/s41598-017-13182-w

Abstract

Although several risk factors for the onset of pancreatic ductal adenocarcinoma (PDAC) have been identified, currently, no scoring system to systemically evaluate the risk of PDAC has been established. In this study, we aimed to use a population of over 1200 patients to build a novel scoring system, and evaluated combined effects of risk factors for PDAC patients.A set of 4904 participants including 1274 PDAC patients and 3630 non-cancer individuals were recruited for the single-center study over 17-year period (1997~2013). Systematic logical analysis were presented for case and control groups, and a risk rating system was constructed to assess combined risk factors. Seven independent risk factors were identified with the increased risk of PDAC, were selected into the risk score. A merged risk assessment model was established, demonstrating significantly increased PDAC risk in following a number of rising scores. Individuals with scores from 1 to more than 4, the responding OR (95% CI) were 3.06 (2.57~3.65), 7.08 (5.63~8.91), 22.4 (14.2~35.4), and 31.4 (12.7~77.5), respectively. The integer-based risk score in the study can be used for risk stratification to accurately evaluate PDAC occurrence at an early stage. This scoring system provides an accurate risk assessment of PDAC risk.

Highlights

Pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic malignancy, is a high lethal pancreatic tumor
88.2% pancreatic ductal adenocarcinoma (PDAC) patients had their duration of the disease less than 6 months, 64.1% had their location in pancreas head to neck, and 26.2% underwent radical surgery
Compared with the control group, the percentage of PDAC patients was higher in smoking, family history of PDAC, diabetes, chronic pancreatitis, and cholecystectomy

Summary

Introduction

Pancreatic ductal adenocarcinoma (PDAC), the most common type of pancreatic malignancy, is a high lethal pancreatic tumor. Single risk factor assessment studies show that 30%~40% of PDAC cases are attributable to known factors including family history, genetic disorders, environmental exposure, tobacco use, occupation and job exposures, medical conditions and lifestyle factors[5]. Both demographics and medical characteristics have an effect on the increased risk for PDAC occurrence, such as smoking[5,9,10], heavy amounts of alcohol drinking[11,12,13,14], diabetes[15,16,17,18], chronic pancreatitis[19,20], and family history of PDAC5,21. Associations between combined variables multiple risks of PDAC were examined

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