Cigarette smoking, environmental tobacco smoke exposure and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition

Alina Vrieling, H Bas Bueno-de-Mesquita, Hendriek C Boshuizen, Dominique S Michaud, Marianne T Severinsen, Kim Overvad, Anja Olsen, Anne Tjønneland, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Rudolf Kaaks, Sabine Rohrmann, Heiner Boeing, Ute Nöthlings, Antonia Trichopoulou, Eftihia Moutsiou, Vardis Dilis, Domenico Palli, Vittorio Krogh, Salvatore PanicoRosario Tumino, Paolo Vineis, Carla H van Gils, Petra H M Peeters, Eiliv Lund, Inger T Gram, Laudina Rodríguez, Antonio Agudo, Nerea Larrañaga, María-José Sánchez, Carmen Navarro, Aurelio Barricarte, Jonas Manjer, Björn Lindkvist, Malin Sund, Weimin Ye, Sheila Bingham, Kay-Tee Khaw, Andrew Roddam, Tim Key, Paolo Boffetta, Eric J Duell, Mazda Jenab, Valentina Gallo, Elio Riboli

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104 Citations (Scopus)


Cigarette smoking is an established risk factor for pancreatic cancer. However, prospective data for most European countries are lacking, and epidemiologic studies on exposure to environmental tobacco smoke (ETS) in relation to pancreatic cancer risk are scarce. We examined the association of cigarette smoking and exposure to ETS with pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). This analysis was based on 465,910 participants, including 524 first incident pancreatic cancer cases diagnosed after a median follow-up of 8.9 years. Estimates of risk were obtained by Cox proportional hazard models and adjusted for weight, height, and history of diabetes mellitus. An increased risk of pancreatic cancer was found for current cigarette smokers compared with never smokers (HR = 1.71, 95% CI = 1.36-2.15), and risk increased with greater intensity and pack-years. Former cigarette smokers who quit for less than 5 years were at increased risk of pancreatic cancer (HR = 1.78, 95% CI = 1.23-2.56), but risk was comparable to never smokers after quitting for 5 years or more. Pancreatic cancer risk was increased among never smokers daily exposed to ETS (for many hours) during childhood (HR = 2.61, 95% CI = 0.96-7.10) and exposed to ETS at home and/or work (HR = 1.54, 95% CI = 1.00-2.39). These results suggest that both active cigarette smoking, as well as exposure to ETS, is associated with increased risk of pancreatic cancer and that risk is reduced to levels of never smokers within 5 years of quitting.

Original languageEnglish
Pages (from-to)2394-2403
Number of pages10
JournalInternational Journal of Cancer
Issue number10
Publication statusPublished - 2010
Externally publishedYes


  • Adult
  • Aged
  • Cohort Studies
  • Environmental Exposure/adverse effects
  • Europe/epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Odds Ratio
  • Pancreatic Neoplasms/epidemiology
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Smoking/adverse effects
  • Time Factors
  • Tobacco Smoke Pollution/adverse effects

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