Diabetes mellitus, other medical conditions and familial history of canceras risk factors for pancreatic cancer

In a population-based case-control study of pancreatic cancer conducted in three areas of the USA, 484 cases and 2099 controls were interviewed to eva luate the aetiologic role of several medical conditions/interventions, incl uding diabetes mellitus, cholecystectomy, ulcer/gastrectomy and allergic st ates. We also evaluated risk associated with family history of cancer. Our findings support previous studies indicating that diabetes is a risk factor for pancreatic cancer, as well as a possible complication of the tumour. A significant positive trend in risk with increasing years prior to diagnosi s of pancreatic cancer was apparent (P-value for test of trend = 0.016), wi th diabetics diagnosed at least 10 years prior to diagnosis having a signif icant 50% increased risk. Those treated with insulin had risks similar to t hose not treated with insulin (odds ratio (OR) = 1.6 and 1.5 respectively), and no trend in risk was associated with increasing duration of insulin tr eatment. Cholecystectomy also appeared to be a risk factor, as well as a co nsequence of the malignancy. Subjects with a cholecystectomy at least 20 ye ars prior to the diagnosis of pancreatic cancer experienced a 70% increased risk, which was marginally significant. In contrast, subjects with a histo ry of duodenal or gastric ulcer had little or no elevated risk (OR = 1.2, c onfidence interval = 0.9-1.6). Those treated by gastrectomy had the same ri sk as those not receiving surgery, providing little support for the hypothe sis that gastrectomy is a risk factor for pancreatic cancer. A significant 40% reduced risk was associated with hay fever, a non-significant 50% decre ased risk with allergies to animals, and a non-significant 40% reduced risk with allergies to dust/moulds. These associations; however, may be due to chance since no risk reductions were apparent for asthma or several other t ypes of allergies. In addition, we observed significantly increased risks f or subjects reporting a first-degree relative with cancers of the pancreas (OR = 3.2), colon (OR = 1.7) or ovary (OR = 5.3) and non-significantly incr eased risks for cancers of the endometrium (OR = 1.5) or breast (OR = 1.3). The pattern is consistent with the familial predisposition reported for pa ncreatic cancer and with the array of tumours associated with hereditary no n-polyposis colon cancer.