Mo1413 Smoking and Family History of Cancer, Not Diabetes Mellitus, Were Associated With Younger Age of Onset in Japanese Pancreatic Cancer Patients

Abstract

Background: Smoking, alcohol or family history of specific cancers is reported to be associated with younger age of onset of pancreatic cancer (PC) in Western countries. We conducted this retrospective analysis to confirm these associations in Japanese PC patients. In addition, the association of diabetes mellitus (DM), which is bidirectionally related to PC, was evaluated. Methods: We retrospectively reviewed the medical records of 654 cases with PC diagnosed at our institute between Dec. 1993 and Oct. 2012. We examined the association between the onset age of PC and variables including gender, cigarette smoking, alcohol consumption, DM, and family history of cancer, especially PC. DM was defined as follows: fasting blood glucose was 126 mg/dl or more, HbA1c (National Glyocohemoglobin Standardization Program, NGSP) was 6.1% or more, or under medication for DM. Results: The mean age of PC diagnosis was 67.5 years (95% confidence interval [CI], 66.7-68.3) and 393 cases (60%) were male. DM was long-standing (.2 years in duration) in 141 cases (21.6%) and newonset (within 2 years in duration) in 174 cases (26.6%). In total, 315 cases (48.2%) had DM. Category of smoking habit was as follows: current smokers in 171, past smokers in 179, and never smokers in 304. Daily alcohol consumption was .80 g in 38 cases. Family history of cancer among first degree relatives was present in 221 patients: PC, 26 cases; colorectal cancer, 26 cases; breast cancer, 9 cases; and ovarian cancer, 2 cases. Current smokers were younger (63.7 [62.2-65.2] years, P ,0.001) at PC onset than past smokers (69.2 [67.7-70.7] years) and never smokers (68.5 [67.4-69.7] years); however, difference was not significant between current smokers and past smokers of cigarette abstinence within 10 years (n = 58, 65.2 [62.6-67.7] years, P = 0.346). Among current smokers, there was a dose-related decrease in onset age of PC. Heavy drinkers ( .80 g of alcohol/day) were associated with younger onset (63.7 [60.4-67.0] vs. 67.7 [66.9-68.5] years, P = 0.020). Male gender (-1.4 years, P = 0.085), family history of cancer (-3.1 years, P ,0.001), and family history of PC (-3.9 years, P = 0.061) were also associated with younger onset. Meanwhile, patients with long-standing DM were older (70.3 [68.6-72.0] years, P = 0.001) than those with new-onset DM (66.6 [65.1-68.2] years) and those without DM (66.7 [65.667.8] years). In multivariate analysis, current smoker (-5.1 years, P ,0.001), long-standing DM (+3.6 years, P ,0.001), and family history of cancer (-3.1 years, P ,0.001) were significantly associated with onset age of PC. Conclusion: In Japanese PC patients, current smokers and family history of cancer were associated with younger age of onset of PC. Conversely, long-standing DM was associated with late onset of PC.